[Epilepsy in adults and elderly subjects. Epidemiological aspects, therapeutic strategies]

The important and quite amazing increase in frequency of epileptic seizures and epilepsy in patients older than 60 years is now recognized as a valid epidemiologic phenomenon. This has been emphasized in the last epidemiologic studies performed with an identical methodology in our industrialized countries. This could in part be explained by the growth of the aged population, by the ageing itself and by a larger exposition to the various risk factors existing at this age. The first is represented by cerebrovascular diseases, but cerebral involution--per se--is surely involved. Prescription of antiepileptic drugs in these patients has to be adapted to the individual cautiously. Pharmacokinetics and pharmacodynamic variations are more frequent than in other populations. On the other hand, drug interactions seem to be more frequent and severe because of the polytherapy prescribed for multiple other diseases. Intellectual or sensorial decline may explain the imperfect compliance observed in these patients.