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¹Department of Medicine, Kingston Public Hospital The University of the West Indies, Kingston, Jamaica. amzamd@yahoo.com

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Summary

This summary is machine-generated.

Elderly patients with multiple health issues can be challenging to diagnose. This case highlights that epilepsy, especially non-convulsive seizures, should be considered for altered sensorium episodes.

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Area of Science:

Geriatric Medicine
Neurology
Cardiology

Background:

A 74-year-old male with chronic obstructive pulmonary disease and ischemic heart disease experienced recurrent episodes of altered sensorium and falls.
Initial investigations revealed cardiac conduction abnormalities, leading to pacemaker insertion.

Observation:

Despite pacemaker implantation, the patient continued to have recurrent syncopal attacks.
Observed events were stereotyped, lasting up to two hours, and resolved with intravenous diazepam.
Subsequent treatment with anti-epileptic drugs resulted in complete cessation of episodes.

Findings:

The patient's episodes were diagnosed as epilepsy, specifically non-convulsive seizures.
Anti-epileptic drug therapy proved effective in managing the condition.

Implications:

In elderly patients with multiple comorbidities, altered sensorium requires a broad differential diagnosis.
Epilepsy, particularly non-convulsive seizures, must be considered in the evaluation of paroxysmal alterations in consciousness in the elderly.