Background: With increasing life expectancy, the incidence rate of epilepsy in the elderly has considerably increased in recent decades. This leads to new diagnostic and therapeutic challenges.
Objectives: Recognition of the special clinical features of epilepsy in the elderly is essential for diagnosis, therapy and prognosis. Special consideration is placed on comorbidity and drug interactions.
Methods: The literature and new developments in this field are reviewed and discussed.
Results: Epilepsy often presents in patients older than 60 years for the first time. The etiology of epilepsy in the elderly is heterogeneous with most belonging to symptomatic epilepsies that are associated with an underlying structural lesion of the brain. Epilepsy in the elderly is distinguished from that in other age groups by its clinical presentation. The treatment of seizures in the elderly is a particular challenge because not only due to comorbidity and co-medication but also because of metabolic changes in this age group.
Conclusion: Epilepsy in the elderly has diagnostic and therapeutic features that require careful clinical assessment and differentiated therapy.