Misleading presentation of epilepsy in elderly people

Four elderly patients with epilepsy are described. The seizures took the form of abrupt loss of consciousness without tonic/clonic movements, followed by prolonged loss of consciousness or drowsiness. In three cases, there had been a long history of blackouts before the diagnosis was made. The diagnosis of epilepsy in these cases was made on clinical grounds. In each case, the event was either witnessed by medical observers or an eye-witness account was obtained. In every case, there had been repeated, and apparently precisely similar, transient disturbances of consciousness, with complete recovery in the intervals. All of the patients had abnormal EEGs.