An article by Brody, Elder and Kwan in Lancet Neurology in 2009, volume 8, page 1019 points out that epilepsy is most likely to develop, not in childhood as we previously thought, but in the senior years of life. Causes are variable, but particularly relevant are strokes, Alzheimer's disease, brain tumors and head trauma. Seizures may not be obvious in seniors, possibly consisting only of confusion, behavior change, twitching, falls for unknown reasons or loss of consciousness. Blood flow problems due to heart disease particularly needs to be ruled out. Medication treatment is more complex in seniors, because seniors tend to be more sensitive to side effects of medicines and to be taking numerous other medications that can produce drug interactions. No one drug is best, but a few controlled studies in seniors suggest that newer anti-seizure medications tend to have better side effect profiles than do older medicines. As our population ages, gathering more knowledge on seizures in seniors will become ever more important.

For more information see our section on Seniors.

Robert S. Fisher, M.D., Ph.D.
Editor-in-Chief, epilepsy.com