Seizures in elderly people - causes, diagnosis and treatment

  • January 12, 2024
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Seizures in elderly people are very common. According to the Centers for Disease Control, of the 3 million adults with epilepsy in the United States, around 1 million are aged 55 or above. And, as the US population continues to get older, the proportion of senior citizens with epilepsy is likely to increase. 

Diagnosing and treating seizures in elderly people can be challenging - especially because many seizure symptoms might be mistaken for the person ‘just getting older’. Let’s learn more about the causes of seizures in elderly people, how they are treated, and the outlook. 

What is epilepsy?

Epilepsy is the name for a brain condition that causes a person to have two or more seizures. A seizure is when there is a sudden burst of electrical activity in the brain. Our brains are constantly sending tiny electrical signals, but during a seizure, those signals get ‘scrambled’. Seizures are usually short, lasting from just a few seconds up to five minutes (but can last longer). 

Depending on where in the brain the seizure starts, it can cause lots of different symptoms:

  • Lip smacking
  • Repetitive movements with hands or feet
  • Jerking or twitching
  • Staring into space
  • Crying out
  • Short term memory loss or confusion
  • Being unable to speak
  • Falling down and shaking

Diagnosing seizures in elderly people can be difficult because some symptoms can be easily mistaken for other conditions. For example, people often have short term memory problems after a seizure, but this can also be a symptom of dementia. Similarly, people may fall over during a seizure, but this could also be a sign of low blood sugar, if they’re being treated for diabetes. 

If an elderly person begins having seizure-like symptoms, it’s very important to visit a doctor as soon as possible to find out what is causing these events. 

What are the main causes of seizures in elderly people?

There are many different causes of seizures in elderly people. To begin with, it’s important to make the difference between people who begin having seizures in later life, and those who have already been living with epilepsy for many years and who are getting older. 

What causes seizures in elderly people for the first time?

There are many different causes of seizures in elderly people, including:

That being said, in up to 50% of senior patients, the cause is unknown.

Epilepsy as you get older

If you already have epilepsy and have been living with it for several years, it’s important to continue working closely with your physician. There have been surprisingly few studies into how epilepsy changes as people get older. Research suggests that it can increase your risk of certain conditions such as dementia. As you get older, continue visiting your doctor regularly, and tell them about any new or unexpected experiences. 

Related: How does the epilepsy experience change as you get older?

Diagnosing seizures in elderly people

Diagnosing epilepsy in senior citizens can be difficult, because seizure symptoms may look similar to other issues affecting older people. Your doctor will use some of the following methods to help understand what might be happening:

  • Medical history: Your doctor will want to learn about your full medical history, including any previous seizure-like experiences, head injuries, strokes and other conditions. Also tell them about any medications you take. 
  • Description of the events: Your doctor will want a detailed description of the events - including what you were doing beforehand, and what happened. If you can’t remember, then ask someone who’s witnessed the event to come along. If at all possible, ask them to record a video next time you have these experiences and show this to your doctor. 
  • Blood tests: A blood test can help rule out certain conditions that may also cause fainting and seizure-like events. 
  • Brain scans: There are various kinds of brain scans that can help diagnose epilepsy, including EEG, MRI and CT scans.

Suggested: What you need to know following an epilepsy diagnosis

Treatment for seizures in the elderly

The most common treatment for seizures in elderly people are anti-seizure medications. They usually come as pills, powders or liquids you take by mouth, and help to regulate electrical activity in your brain. This makes seizures less likely to happen. 

Taking anti-seizure medications can be complicated if you are taking medications for other conditions. Interactions between two different drugs can have negative side effects. So if your physician does recommend an epilepsy drug, make sure you tell them about any other medications you’re taking. 

Seizures in the elderly: prognosis

The outlook for elderly people who have epilepsy can vary significantly. For many people seizures are a sign of another underlying condition. If you can get this underlying condition treated, then the seizures may also stop too. 

Other times, you may continue having seizures for the long term. Nevertheless, with appropriate treatment and some lifestyle changes, the seizures can be managed and their impact reduced. 

The most important thing is to see your doctor about seizures (or seizure-like events) as soon as possible. The earlier you get a diagnosis, the better your long term prognosis. 

If you receive an epilepsy diagnosis, try using Epsy, a free app for your smartphone. The easy-to-use app lets you record seizures, set medication reminders, note down medication side effects, and even share information directly with your treatment team.

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