Epilepsy in older adults

Seizures in older adults exist during an extremely common time period of the life cycle. They are often overlooked because they are more likely to be subtle and because of the erroneous perception that seizures are more typically seen in younger adults. Clinicians need to be alert to the fact that seizures are frequent in the older adult population and must be included in the differential diagnosis of older adults with paroxysmal neurological events. Seizures appear slightly differently in the elderly than younger adults as subtle and may not be recalled by the patient. Managing seizures in older adults implies sensitivity to antiseizure medication (ASM). Therefore, starting with low doses of ASM and titrating ASM slowly is a good practice to ensure tolerability. The ultimate goal is balancing seizures and side effects to provide the best quality of life understanding pharmacologic and pharmacokinetic differences in the treatment of older adults with epilepsy.