[Epilepsy in the elderly: diagnostic and therapeutic problems]

Abstract

Epilepsy that first appears at the age of 65 years or older is a type of late-onset epilepsy. The diagnosis comprises the medical history and an EEG; a specialist should be consulted at an early stage. For the therapy of epilepsy in the elderly, some special points must be observed. Thus, for example, because of the usually changed pharmacokinetics and -dynamics in older people, medications must often be given at a lower dosage. Frequently, there are coexisting internal or other neurological diseases. Hence, adverse drug reactions can occur during the treatment. Second generation antiepileptic drugs (lamotrigine, topiramate, levetiracetam) are tolerated better and should be used preferentially over antiepileptic drugs of the first generation (carbamazepine, phenytoin, phenobarbital, primidone).