Geriatric Epilepsy

Summary: After stroke and dementia, geriatric epilepsy is the third most common neurologic condition. This chapter focuses on the epidemiology, etiology, clinical features or semiology, differential diagnosis, seizure mechanisms, and treatment of geriatric epilepsy. Epilepsy in old age is generally an expression of an underlying disease of the brain. Symptomatic causes of epilepsy in the elderly are usually due to a cerebrovascular disease or neurodegenerative disease. Epileptic seizures result from an abnormal and excessive discharge of neurons, and this is clinically manifested by sudden, diverse, transitory symptoms, including altered consciousness and motor, sensory, or psychiatric events. Epileptic seizures can be mimicked by nonepileptic events that are common in the elderly age group. Elderly patients with epilepsy have a favorable response and tolerance to new-generation antiepileptic drugs (AEDs). Moreover, the AED dosages are lower due to pharmacokinetic changes that occur in the older age group.