Epilepsy In The Elderly: Challenges And Considerations In Diagnosis And Treatment

Elderly man lies on floor, clutching heart.

Diagnosing epilepsy in older individuals can be difficult as seizures are often mistaken for symptoms of other conditions like dementia or attributed to ageing.

At any given time, the human body is exposed to multiple ailments and diseases, most of which can be particularly debilitating for elderly patients. Epilepsy is one such example and is a neurological disorder that causes seizures and convulsions. And to make matters worse, studies have suggested that the incidence of epilepsy may even increase with age.

Seizures Happen Because Of Excessive Electrical Activity In Specific Clusters Of Brain Cells

A chronic neurological disorder impacts approximately 50 million individuals globally.

  • It manifests through recurring seizures and brief episodes of uncontrollable movement that can affect a specific body area (partial) or the entire body (generalized). These seizures may also coincide with periods of unconsciousness and loss of control over bowel or bladder function.
  • This can originate in various regions of the brain. These episodes range from momentary lapses in focus or muscle twitches to intense and prolonged convulsions. Additionally, the frequency of seizures can vary widely, from occurring less than once a year to happening multiple times per day.

Symptoms Of Seizures Differ Based On Their Type

Epilepsy typically begins either during childhood or in the later stages of adulthood, although it can emerge at any point in life.

  • As epilepsy stems from specific brain activity, seizures have the potential to impact any brain function. These symptoms may encompass Temporary confusion, staring spells, muscles becoming rigid, loss of consciousness and psychological manifestations like fear, anxiety, or d j vu.
  • Individuals aged 65 and above exhibit the highest occurrence of epilepsy, constituting nearly a quarter of all new cases. With the ageing demographic, the prevalence of epilepsy among older adults is rising, necessitating a deeper understanding of its impacts on the elderly population.
  • In some cases, individuals with epilepsy may experience alterations in their behaviour or exhibit symptoms of psychosis. The likelihood of experiencing seizures of any form notably escalates beyond the age of 60 and is often attributed to concurrent neurological conditions like dementia or stroke.
  • The common causes of epilepsy in older individuals include strokes, brain injury, brain tumours, and degenerative conditions like dementia medical ailments affecting brain function include sleep deprivation, stress, and depression.

About Half Of All Seizures Occurring In Older Adults Lack Identifiable Causes:

It’s crucial to accurately differentiate between epilepsy and other seizure disorders common in older individuals. Seizure symptoms in older people can differ from those in younger people. Diagnosis can be challenging due to vague symptoms, short-lived episodes, and lack of witnesses. Diagnosing epilepsy in older individuals can be difficult as seizures are often mistaken for symptoms of other conditions like dementia or attributed to ageing.

(This article has been verified by Dr Mitalee Kar, Sr. Consultant Neurology, CARE Hospitals, Bhubaneswar)




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