Epilepsy/seizure is the 5th most common neurological condition in nursing home residents*4
*According to an analysis which evaluated 1,186,579 elderly Medicare/Medicaid patients living in nursing homes from 2003–2007.4
Diagnosing epilepsy in older adults may be challenging3
Factors that may complicate diagnosis
- Auras and automatisms that are typical in younger patients may be less common in elderly
- Nonspecific symptoms (eg, confusion, staring)
- Symptoms are often misattributed to seizure mimickers
- Transient global amnesia
- Transient ischemic attacks
Identifying seizure occurrence in older adults
In ~50% of cases, the cause of epilepsy among older adults is unknown.5 When causal determination can be made, it is most frequently due to stroke (33%).5
Seizure symptoms may include:
- Briefly distorted vision2
- Brief loss of speech2
- Confused speech2
- Facial twitching2
- Sporadic memory loss6
- Suspended awareness6
- Hearing or seeing things6
An older person suspected to have had a seizure should undergo rapid assessment by an epilepsy specialist and treatment initiation if indicated7
- Epilepsy Foundation Texas. www.eftx.org/about-epilepsy/. Accessed February 26, 2018.
- Epilepsy Foundation Eastern Pennsylvania. www.efepa.org/living-with-epilepsy/seniors-with-epilepsy/. Accessed February 26, 2018.
- Chong T, D’Souza W. Epilepsy in the elderly. In: Shorvon S, et al, eds. Oxford Textbook of Epilepsy and Epileptic Seizures. Oxford, United Kingdom: Oxford University Press; 2013:201-210.
- Birnbaum AK, Leppik IE, Svendsen K, Eberly LE. Prevalence of epilepsy/seizures as a comorbidity of neurologic disorders in nursing homes. Neurology. 2017;88(8):750–757.
- Epilepsy Foundation. Seniors with Epilepsy. https://www.epilepsy.com/learn/special-populations/seniors-and-epilepsy/seniors-epilepsy. Accessed February 8, 2018.
- How to spot epilepsy in seniors when it looks like dementia. Brain and Spine Team Cleveland Clinic. https://health.clevelandclinic.org/2014/10/how-to-spot-epilepsy-in-seniors-whenit-looks-like-dementia/. October 14, 2014. Accessed January 31, 2018.
- Brodie MJ, Kwan P. Epilepsy in elderly people. BMJ. 2005;331:1317-1322.