seizures in the elderly
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Etiology
- ischemic stroke or hemorrhagic stroke (most common cause of new-onset seizures) 50%
- intracranial mass lesion
Clinical manifestations
- alert & oriented, but unable to recognize family or follow simple commands*
- subacute decline in function, cognitive impairment
- urinary incontinence, fecal incontinence*
* case presentation does not specify type of seizure[8]
Diagnostic procedures
- electroecephalography
Radiology
Management
- anticonvulsants often given to elderly after a 1st seizure
- consider drug interactions & drug adverse effects in selection of an anticonvulsant[1][3]
- lamotrigine, levetiracetam & gabapentin may be better tolerated than carbamazepine[3]
- supplement Ca+2 & vitamin D in women (bone mineral density may be reduced by anticonvulsants[4]
More general terms
References
- ↑ 1.0 1.1 Leppik IE, Bergey GK, Ramsay RE, Rowan AJ, Gidal BE, Birnbaum AK, Elliott MB. Advances in antiepileptic drug treatments. A rational basis for selecting drugs for older patients with epilepsy. Geriatrics. 2004 Dec;59(12):14-8, 22-4. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15667018
- ↑ Leppik IE, Bergey GK, Ramsay RE, Rowan AJ, Gidal BE, Birnbaum AK, Elliott MB. Advances in antiepileptic drug treatments. A rational basis for selecting drugs for older patients with epilepsy. Geriatrics. 2004 Dec;59(12):14-8, 22-4. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15667018
- ↑ 3.0 3.1 3.2 Journal Watch 25(15):118-19, 2005 Rowan AJ, Ramsay RE, Collins JF, Pryor F, Boardman KD, Uthman BM, Spitz M, Frederick T, Towne A, Carter GS, Marks W, Felicetta J, Tomyanovich ML; VA Cooperative Study 428 Group. New onset geriatric epilepsy: a randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology. 2005 Jun 14;64(11):1868-73. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15955935
- ↑ 4.0 4.1 Prescriber's Letter 10(1):4 2003
- ↑ 5.0 5.1 Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
- ↑ Angus-Leppan H. First seizures in adults. BMJ. 2014 Apr 15;348:g2470. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24736280
- ↑ Motika PV, Spencer DC. Treatment of Epilepsy in the Elderly. Curr Neurol Neurosci Rep. 2016 Nov;16(11):96. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27628963
- ↑ 8.0 8.1 Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
- ↑ Ip Q, Malone DC, Chong J, Harris RB, Labiner DM. An update on the prevalence and incidence of epilepsy among older adults. Epilepsy Res. 2018 Jan;139:107-112. Epub 2017 Dec 5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29220741
- ↑ Sen A, Jette N, Husain M, Sander JW. Epilepsy in older people. Lancet. 2020 Feb 29;395(10225):735-748. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32113502 Review.