Epilepsy in the elderly: Special considerations and challenges
The elderly are generally defined as those over 60 or 65 years old, but they are a heterogeneous group and may be subdivided into categories based on age and health status. The incidence of epilepsy is highest in the elderly. With a progressive increase in life expectancy, this is the fastest growin...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2014;volume=17;issue=5;spage=18;epage=26;aulast=Acharya |
| _version_ | 1818026609883480064 |
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| author | Jayant N Acharya Vinita J Acharya |
| author_facet | Jayant N Acharya Vinita J Acharya |
| author_sort | Jayant N Acharya |
| collection | DOAJ |
| description | The elderly are generally defined as those over 60 or 65 years old, but they are a heterogeneous group and may be subdivided into categories based on age and health status. The incidence of epilepsy is highest in the elderly. With a progressive increase in life expectancy, this is the fastest growing segment of patients with epilepsy. Older patients most often have focal seizures, with less prominent auras and automatisms, and longer duration of postictal confusion compared to younger patients. Status epilepticus is common and has a high mortality. The most common specific etiology is cerebrovascular disease, but the cause remains unknown in many patients. Diagnosis can be challenging because of several patient-related, physician-related and investigation-related factors. Over-diagnosis and under-diagnosis are common. Treatment is complicated by the presence of physiological changes related to aging, co-morbidities and cognitive problems as well as concerns regarding drug interactions and medication adherence. Seizures can be controlled in most patients with low doses of a single anti-epileptic drug (AED). Tolerability is an important factor in selection of an AED, as elderly patients tend to be highly sensitive to side effects. Drug-resistant epilepsy is uncommon. Epilepsy surgery, especially temporal lobectomy, can be performed in older patients with good results. More studies addressing the pathophysiological mechanisms of epilepsy in this age group, and greater inclusion of the elderly in clinical trials, as well as development of comprehensive care models are needed to provide optimal care to these patients. |
| first_indexed | 2024-12-10T04:34:44Z |
| format | Article |
| id | doaj.art-fbbfc37ec5014b92b95bba9f2c4be7a1 |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-12-10T04:34:44Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-fbbfc37ec5014b92b95bba9f2c4be7a12022-12-22T02:02:03ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492014-01-01175182610.4103/0972-2327.128645Epilepsy in the elderly: Special considerations and challengesJayant N AcharyaVinita J AcharyaThe elderly are generally defined as those over 60 or 65 years old, but they are a heterogeneous group and may be subdivided into categories based on age and health status. The incidence of epilepsy is highest in the elderly. With a progressive increase in life expectancy, this is the fastest growing segment of patients with epilepsy. Older patients most often have focal seizures, with less prominent auras and automatisms, and longer duration of postictal confusion compared to younger patients. Status epilepticus is common and has a high mortality. The most common specific etiology is cerebrovascular disease, but the cause remains unknown in many patients. Diagnosis can be challenging because of several patient-related, physician-related and investigation-related factors. Over-diagnosis and under-diagnosis are common. Treatment is complicated by the presence of physiological changes related to aging, co-morbidities and cognitive problems as well as concerns regarding drug interactions and medication adherence. Seizures can be controlled in most patients with low doses of a single anti-epileptic drug (AED). Tolerability is an important factor in selection of an AED, as elderly patients tend to be highly sensitive to side effects. Drug-resistant epilepsy is uncommon. Epilepsy surgery, especially temporal lobectomy, can be performed in older patients with good results. More studies addressing the pathophysiological mechanisms of epilepsy in this age group, and greater inclusion of the elderly in clinical trials, as well as development of comprehensive care models are needed to provide optimal care to these patients.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2014;volume=17;issue=5;spage=18;epage=26;aulast=AcharyaDiagnosiselderlyepilepsytreatment |
| spellingShingle | Jayant N Acharya Vinita J Acharya Epilepsy in the elderly: Special considerations and challenges Annals of Indian Academy of Neurology Diagnosis elderly epilepsy treatment |
| title | Epilepsy in the elderly: Special considerations and challenges |
| title_full | Epilepsy in the elderly: Special considerations and challenges |
| title_fullStr | Epilepsy in the elderly: Special considerations and challenges |
| title_full_unstemmed | Epilepsy in the elderly: Special considerations and challenges |
| title_short | Epilepsy in the elderly: Special considerations and challenges |
| title_sort | epilepsy in the elderly special considerations and challenges |
| topic | Diagnosis elderly epilepsy treatment |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2014;volume=17;issue=5;spage=18;epage=26;aulast=Acharya |
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