Seizures and Epilepsy in the Elderly: Diagnostic and Treatment Considerations

Purpose of Review The purpose of this review is to highlight important clinical aspects in diagnosis and management of epilepsy in the elderly and to highlight recent literature and its relevance to current practice. Recent Findings Recent studies have shown that elderly patients are under referred for evaluation to epilepsy monitoring units and for epilepsy surgery, which has been demonstrated to be safe and effective in this population. Summary The elderly are at increased risk for acute symptomatic seizures and epilepsy. Accurate diagnosis can be challenging in older patients due to limitations in history, atypical symptoms, and medical comorbidities. Inpatient video-EEG monitoring is a valuable tool for the clinician when diagnosis is unclear or patients are unresponsive to medication. Drug resistance rates in the elderly are similar to younger adults with epilepsy, but elderly patients are less likely to be referred for epilepsy monitoring unit admissions and epilepsy surgery, despite evidence of safety and effectiveness.