Seizures: common causes and treatment in the elderly

Seizures occur in the elderly with a frequency, on an age-specific basis, that is as high as in the neonatal period. However, the spectrum of etiologies and the management of seizures reflect the effects of aging and give rise to certain special considerations. Structural brain diseases such as stroke and tumor account for the majority of cases of new seizures over age 65. Correct identification of the cause of seizures is important for initiating the appropriate therapy. Selection of an anti-convulsant depends partially upon the side effects to be avoided in specific patients. Complete remission of late-life seizures is uncommon, although excellent seizure control can usually be achieved with the correct medication.