Epilepsy

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk
Reference work entry

Abstract

Epilepsy often develops for the first time in old age. The active epilepsy prevalence rate is approaching 1.5% amongst the 65 years and older which is about twice the rate of younger people. Aetiology of seizures varies amongst the different age groups. In the elderly, cerebrovascular and neurodegenerative diseases are the leading causes of epilepsy. In the elderly, stroke is the common cause of seizures. Status epilepticus occurs in 12% of stroke patients and remains a life-threatening event. Periodic lateralising epileptiform discharges (PLEDs) have been commonly associated with cerebral infarction but also with other cerebral diseases such as encephalitis, tumour and demyelinating diseases. Manifestations depend on the type of seizure which may be classified as partial (focal) or generalised. Elderly individuals who have seizures must be carefully evaluated. Investigations should include neuroimaging. A common manifestation of epilepsy in the elderly is non-convulsive status epilepticus (NCSE). Most elderly people respond well to antiepileptic drugs (AEDs) including low doses of AED and are more likely to remain seizure-free than the younger patients. Monotherapy is the main goal of epileptic treatment, and majority can be controlled on a single agent. The doses that seem to be more appropriate are in the lower levels than the therapeutic ones, and the clinician is best placed to decide. Patients with epilepsy have neuropsychological impairments including emotional distress, behavioural disorders and social isolation and the quality of life.

Keywords

Epilepsy Seizures Status epilepticus Periodic lateralising epileptiform discharges (PLEDs) Non-convulsive status epilepticus (NCSE) 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 1
  • Gary Cheuk
    • 2
  1. 1.The University of SydneyWestmead Clinical SchoolWestmeadAustralia
  2. 2.Rehabilitation and Aged Care ServiceBlacktown-Mt Druitt HospitalMount DruittAustralia

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