[Paroxysmal symptoms in the elderly; epileptic seizures or not]

Epilepsy and seizures in the elderly are characterized by less obvious motor symptoms and longer consciousness disturbance, and thus more diseases for differential diagnosis are raised than those in the young. It is necessary to take careful and systematic history to make a diagnosis of seizure, its types and finally epilepsy syndrome. Electroencephalography is one of the most important methods to evaluate the epileptic seizures and the conditions of patients; however, even positive findings need consistency with clinical manifestation. Treatment option, i. e., how soon or how long antiepileptic drugs are used for therapy, can be modified by the several factors such as degree of seizures, suppression before treatment, classification of seizure types and epilepsy syndromes, comorbidities, and concomitant medications.