Epilepsy in the Elderly

Ann Johnston; Phil EM Smith

Disclosures

Expert Rev Neurother. 2010;10(12):1899-1910. 

In This Article

Clinical Presentation

Seizures in the elderly can be more subtle than in younger people. Complex partial seizures are the most common presentation, although may initially evade diagnosis.[30] Older patients are more likely to have an extratemporal epileptic focus[32] and so less commonly report the typical olfactory/déjà vu auras or automatisms typical of younger patients.[33] Should an aura be reported, it may be described only as 'dizziness'.[33] Atypical presentations may also include altered mental status, periods of staring, unresponsiveness, brief losses of consciousness, inattention, memory lapses or confusion. Should major seizures occur, their characteristics are similar to those in younger people – important markers being lateral tongue biting, waking in an ambulance or in hospital, or significant injuries, for example, vertebral fractures or shoulder dislocation. Post-ictal periods may be more prolonged, sometimes for several days.

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