Epilepsy care in nursing facilities: Knowledge gaps and opportunities

Area of Science:

• Geriatric Medicine
• Neurology
• Clinical Pharmacy

Background:

• Epilepsy in older adults presents unique diagnostic and treatment challenges.
• Nursing facility residents with unexplained episodes require urgent assessment for seizures.

Purpose of the Study:

• To highlight the complexities of epilepsy management in the elderly.
• To emphasize the need for improved recognition, assessment, and treatment protocols for seizures in this population.

Main Methods:

• Review of current challenges in diagnosing and treating epilepsy in the elderly.
• Discussion of pharmacodynamic changes and drug interactions with antiseizure medications (ASM) in older adults.
• Identification of strategies to enhance healthcare provider knowledge regarding ASM efficacy and safety.

Main Results:

• Epilepsy in the elderly is often underdiagnosed and undertreated, requiring a multidisciplinary approach.
• Limited clinical trial data exists for ASM tolerability and efficacy in the elderly.
• Over-reliance on enzyme-inducing ASMs is common, despite potential interactions and age-related pharmacodynamic changes.

Conclusions:

• Prompt recognition and management of seizures in the elderly are essential to prevent emergency visits.
• Enhanced healthcare provider education on ASM, including drug interactions and side effect monitoring, is vital.
• Development and implementation of evidence-based treatment protocols are needed for effective elderly epilepsy care.