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[Epilepsy in the very old]
S Steidele1, D Flügel, J Bauer
1Klinik für Epileptologie der Universität Bonn.
Fortschritte Der Neurologie-Psychiatrie
|May 1, 1997
Summary
Epilepsy is a common neurological disease in the elderly, with a higher risk of recurrent seizures and injuries. Early anticonvulsive therapy, considering altered pharmacokinetics, is crucial for managing seizures in older adults.
Area of Science:
- Neurology
- Geriatrics
Context:
- Epilepsy is the third most common neurological disease affecting the elderly population.
- Incidence of epilepsy is higher in the elderly compared to childhood and adolescence.
- Cerebrovascular diseases are the primary cause of seizures in individuals over sixty.
Purpose:
- To discuss the unique aspects of epilepsy in the elderly, including incidence, causes, and risks.
- To outline appropriate anticonvulsive therapy strategies for elderly patients.
- To highlight the importance of considering altered pharmacokinetics in geriatric epilepsy treatment.
Summary:
- The risk of recurrent seizures and seizure-related injuries is elevated in the elderly.
- Early initiation of anticonvulsive therapy with guaranteed compliance is recommended.
- Carbamazepine is the first-line drug, with newer antiepileptics like vigabatrin, gabapentin, and lamotrigine being suitable alternatives due to their pharmacokinetic profiles.
Impact:
- Provides guidance for early and effective management of epilepsy in geriatric patients.
- Emphasizes the need for tailored therapeutic approaches considering age-related physiological changes.
- Contributes to improving seizure control and reducing injury risk in the elderly population.