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Issues when treating epilepsy in the elderly.

B Pohlmann-Eden1

  • 1Bethel Epilepsy Center, Bielefeld, Germany. bernd.pohlmann-eden@evkb.de

Acta Neurologica Scandinavica. Supplementum
|October 22, 2005
PubMed
Summary

Epilepsy in the elderly is common, often caused by ischemia or tumors. Treatment focuses on antiepileptic drugs (AEDs), with newer options showing better tolerability and fewer interactions.

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Area of Science:

  • Neurology
  • Geriatrics
  • Pharmacology

Background:

  • Epilepsy and single seizures are prevalent neurologic disorders in older adults.
  • Ischemia and tumors are leading causes, necessitating a multidisciplinary diagnostic and management approach.

Purpose of the Study:

  • To review the diagnosis and management of epilepsy in the elderly.
  • To discuss age-specific considerations for antiepileptic drug (AED) therapy.

Main Methods:

  • Literature review focusing on epilepsy in the elderly.
  • Analysis of antiepileptic drug (AED) efficacy, tolerability, and drug interactions.

Main Results:

  • Ischemia is the most frequent cause of seizures in the elderly (up to 33%), followed by tumors (approx. 10%).
  • Age-related changes in drug metabolism and increased sensitivity to side effects are critical.
  • Newer AEDs may offer improved tolerability and reduced drug interaction potential compared to older agents.

Conclusions:

  • AED therapy requires careful consideration of age-specific factors.
  • Monotherapy initiated at low doses and titrated slowly is recommended for seizure freedom with minimal side effects.

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