How Do You Get Epilepsy in Later Life?

Anyone with a brain can have epilepsy, however it is one of the most common diseases of the nervous system in older adults, after dementia and stroke. People who are 60 years and older have the highest rate of new epilepsy onset. Epilepsy and seizures that occur later in life are often caused by post stroke, tumor, or cardiovascular issues.  

Causes of Epilepsy in Older Adults

Increasing age, stroke, tumor, and drug habits may cause seizures in older adults. Co-occurring conditions, like depression and heart issues, also cause an increased risk of seizures.

As much as we know about the causes of epilepsy later in life, one-third to one-half of epilepsies in older adults have unknown causes. In some cases, only a first seizure occurs and is not considered epilepsy.

Stroke

Strokes are the most common cause of seizures in older adults. About 10% of stroke survivors experience seizures after the stroke. This is caused by scar tissue forming on brain areas affected by the stroke. These areas send out abnormal electrical signals, which can trigger different types of seizures.

Post-stroke seizures may occur anywhere from 24 hours up to years later. Having a history of stroke, even at a younger age, increases risks of developing epilepsy. Receiving treatment for seizures and following stroke prevention techniques can help improve a person's health.

Other types of cerebrovascular diseases (diseases that affect blood flow to your brain) can also lead to seizures.

Cardiovascular Issues

People with epilepsy later in life have a larger chance of myocardial infarction (heart attack), artery disease, hypertension, and high cholesterol. The link between heart conditions and epilepsy appears to go both ways. Seizures may put strain on pressure in the arteries leading to risk of stroke or heart attack.

People living with epilepsy have a higher risk of cardiac death than people without epilepsy. If you have a history of heart-related issues or epilepsy, it is recommended to ask your doctor about risks for the other condition.  

Types of Dementia

People with dementia, including Alzheimer’s disease, are five to ten times at risk of epilepsy compared to people without dementia. Based on the nature of dementia, it is more difficult to recognize seizures based on the person's behavior and lack of medical history.

Tumor

Slow growing benign brain tumors, called low grade tumors, can cause epilepsy. Seizures originate from the tumor's location. In older adults, seizures caused by tumors have a serious impact on increasing mortality rates.

Brain metastases also contribute to increased risk of epilepsy. This condition often starts in an organ and spreads to the brain.

Traumatic Brain Injury  

While anyone can experience traumatic brain injury (TBI), it is a greater concern for older adults. People 65 years of age or older have an increased risk for TBI. Falls are more likely among the elderly, with some falls contributing to head trauma and seizures.  

A person with head trauma may have bruising or bleeding in the brain that requires immediate medical attention. Prompt medical care reduces the risk of further injury. Seizures can occur within the first week or later, more than a week, after a brain injury.

Drugs and Toxins

Prescription medications, illicit drugs, and alcohol can contribute to seizures in older adults. When a person later in life has a history of long-term hospitalization or serious illness, they are more likely to experience drug-related seizures.  

Prescription drugs that may increase risk of seizure include:

• Antibiotics
• Endocrine medication
• Stimulants
• Toxic levels of anti-seizure medication
• Benzodiazepines (during withdrawal)

Additionally, exposure to toxins, ammonia, copper, lead, or mercury have symptoms similar to seizures.

The Importance of Diagnosis

Some health issues, like heart problems, may appear like seizure symptoms. Visiting a doctor, specialist, or epileptologist to help with accurate diagnosis and starting the best treatment plan.

Seizures in later life are less obvious and easily masked by other health conditions. Cognitive, psychiatric, and ECG screenings can help find underlying conditions.

If you already have an increased risk for stroke, heart attack, or other conditions, talk to your doctor about lifestyle and medication changes to help reduce your risks.