Recognizing epilepsy in older adults
Symptoms to look for in loved ones
WHEN MOST PEOPLE THINK of epilepsy, they picture dramatic convulsions or seizures that affect younger people. Epilepsy is increasingly common among older adults, yet it often goes unrecognized because the signs can be much more subtle.
For years, epilepsy was not widely considered an issue affecting aging populations. We now know that about one in every 1,000 people after age 65 is diagnosed with new-onset epilepsy each year, and that number continues to increase with age.
One of the biggest challenges is that seizures in older adults often look very different from the seizures most people expect. Rather than full-body convulsions, many older patients experience brief episodes of confusion, memory lapses or impaired awareness. These symptoms can easily be mistaken for normal aging, medication side effects or early stages of dementia.
Several medical conditions increase the risk of developing epilepsy later in life. Stroke is the leading cause, particularly during the first year after the event. Dementia, especially early-onset Alzheimer’s disease, is also associated with a significantly higher risk of seizures. Other contributing factors include traumatic brain injury, brain tumors and vascular conditions such as high blood pressure.
Recognizing epilepsy is important because untreated seizures can have serious consequences. Older adults are already at greater risk for falls and injuries, and seizures can further increase those risks. Recurrent seizures may also contribute to worsening memory and cognitive function. Prolonged seizures can become life-threatening if not treated promptly.
The encouraging news is that epilepsy in older adults is highly treatable once it is recognized. For many patients, treatment involves a single anti-seizure medication at a relatively modest dose. Newer medications are generally well-tolerated, and studies have shown that more than 80% of older adults achieve excellent seizure control with one medication alone. When medications are not enough, additional treatment options, including epilepsy surgery and other advanced therapies, may be considered for carefully selected patients.
Seizures should never be considered a normal part of aging. If you or a loved one experiences unexplained episodes of confusion, memory loss, staring spells or periods of impaired awareness, talk with your healthcare provider. Early evaluation can lead to an accurate diagnosis, effective treatment and a better quality of life.
SALLY MATHIAS, M.D., is a neurologist and epilepsy specialist at UK HealthCare’s Kentucky Neuroscience Institute.
