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Epilepsy in Older Adults

Epilepsy in Older Adults

Onset of epilepsy is common in older adults.  In fact, in seniors over 65, epilepsy is the fourth most common neurological disorder after migraine, dementia and stroke.  It is more likely to develop in later life than in earlier stages of life because as people age, the risk of seizures and epilepsy rises.  Despite this information, however, epilepsy often goes unnoticed, is not diagnosed, or symptoms such as confusion, memory problems, falls and dizziness are attributed to aging.

Like in other age groups, up to one-third or one-half of older adults have an undetermined cause of epilepsy.  Common causes include:

  • Vascular (blood vessel) diseases of the brain, such as stroke and aneurysm
  • Head injury
  • Neurodegenerative disorders such as Alzheimer’s or dementia
  • Brain tumour
  • Alcoholism or other substance abuse

Please note that some medications and infections may cause seizures, but they are generally not considered epilepsy.

Challenges in Diagnosis

Diagnosis of epilepsy in this age group can be more challenging, especially if the seizures are subtle or not recognized as signs of seizures.

Seizures or seizure-like activity can be confused for other conditions, such as cardiac conditions, organ failure, diabetes, stroke, migraine, vertigo or medication side effects.  Confusion and altered states could also be due to other causes that are unrelated to epilepsy, such as dementia, psychiatric illness, medications, infections or dehydration.

Many other adults may also have more than one health provider, and poor communication between the providers could lead to vital health information being missed.  It is important to have a relationship with a GP, who can then be the primary coordinator of all of the health information.

Finally, some seniors live alone, which can delay diagnosis even further as no clear description of the seizures are available to the older adult’s care team.

Lifestyle Challenges for Older Adults

Epilepsy in older adults presents a unique set of issues specific to this age group.  It can prove challenging to balance the treatment for epilepsy with medications and treatments for other conditions.  Furthermore, some medications, when taken together, could result in undesired interactions and side effects.

Many older adults who have epilepsy may face limitations in their daily activities.  People who do not have control over their seizures are often restricted from driving a car, and after a lifetime of driving, losing the ability to drive can be difficult.

Older adults are also at an increased risk of falls and injury.  Some medications for epilepsy may also cause a loss of bone density, which can further exacerbate the chance of fractures or other serious harm during a fall.

Prevention and Living Healthily with Epilepsy

Antiepileptic drugs are very effective in controlling seizures in older adults, and sometimes, a low dose is all that is needed, as sensitivity to medication increases with age.  It is important to tell your doctor and pharmacist all of the medications that you are taking so that interactions between the medications are minimized or avoided.

Stroke is a common cause for epilepsy in older adults.  During a stroke, blood supply is cut off or a blood vessel bursts.  In either case, parts of the brain can become damaged or die.  However, you can lower your chances of developing stroke by not smoking, eating a healthy diet, maintaining a healthy weight, getting enough exercise and limiting alcohol use.

Fear of failing, social isolation and loss of independence are concerns for older adults experiencing seizures.  Having good supports and keeping in touch with family, friends and community groups is important to well-being.  Adequate sleep, good diet, stress control, limitation of alcohol, plenty of exercise and stimulating activities often help in seizure management.  There are many resources and ways to help seniors living with epilepsy maintain their quality of life and active lifestyle. 

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