Epilepsy is a neurological condition in which abnormal signals are sent between brain nerve cells, causing unusual body behaviors known as seizures. An estimated 65 million people worldwide experience epilepsy and that approximately 1 in 100 South Africans will suffer from epilepsy at some point in their lifetime.. The daughter of actor Harrison Ford has epilepsy, and he advocates for gaining information about the disorder and treatments. “I’m really aware of what a devastating affliction it can be,” says Ford. “It not only affects the person who suffers from epilepsy, but it affects their entire family.”

A number of other well-known people had epilepsy during their lifetime or have the condition now, including Charles Dickens, Theodore Roosevelt, Neil Young, Florence Griffith Joyner, Prince, Susan Boyle and South African icons like Jonty Rhodes and Vusi Mahlasela. Although epileptic seizures are disruptive, these accomplished individuals have demonstrated that epilepsy does not need to control one’s life.

An epilepsy diagnosis is given when a person has two separate seizures at least 24 hours apart and the seizures do not stem from another known medical condition. For approximately 60 percent of epilepsy patients, there is no discernable reason for the seizures. Seizures occur more frequently with age.

In older adults, seizures are harder to detect because they can cause confusion, memory problems, sensory changes or dizziness, which are often signs of other illnesses such as dementia and cardiovascular issues. Seizures are grouped into classifications based on muscle movement symptoms, such as muscle rigidity and twitching, and non-motor symptoms, such as staring spells and goose bumps. Head injury, brain tumor and stroke are often tied to initial epileptic seizures in senior adults.
Challenges of epilepsy in the elderly include:

Epilepsy & Dementia

In an article in Scientific American, scientists studied the link between silent non-convulsive seizures and Alzheimer’s. The surprising finding indicates that anti-seizure medications given to epilepsy patients may also help lower or even reverse cognitive decline in Alzheimer’s disease, a treatment option that could be available relatively quickly.

Researcher led by Lennart Mucke and Keith Vossel of the Gladstone Institute of Neurological Disease, San Francisco, California, found that in patients with epileptic brain activity and either amnestic mild cognitive impairment (aMCI) or Alzheimer’s Disease, as was previously found in mouse models, epileptic activity often manifests as non-convulsive seizures. “Seizures represent an aspect of Alzheimer’s disease that may be treatable,” Vossel told Alzforum. “If nothing else, it could improve symptoms, but in the best-case scenario, we might actually target some mechanisms at play early in the disease process by suppressing aberrant network activity.”

Epilepsy Symptoms in Elderly

  • Confusion
  • Suspended awareness
  • Hearing or seeing things
  • Sporadic memory loss
  • Risk of falling & other injuries
  • Increased bone loss with some epilepsy drugs
  • Challenge of balancing epilepsy treatment with other health concerns/medications

“Care needs to be taken to ensure elderly, who have been known to experience seizures in the past and who reside in a care home or care village, receive special care to prevent the above mentioned risks.” Says Johannes van Niekerk, one of Jura Care Village’s Directors.

“When older adults have a seizure, their symptoms may in fact be mistaken for dementia, including Alzheimer’s disease, depression or just normal aging,” says epileptologist Andreas Alexopoulos, MD. Nearly half of all seizures in older adults have unknown causes. Among the conditions we know cause epilepsy, the primary one is stroke.

Treating Seizures In Elderly

“Epilepsy is tougher to treat in seniors than in younger patients,” Dr. Alexopoulos says. “Yet making the correct choice of a medication that is well tolerated and effective can be very rewarding.”

Seizures are often diagnosed based on the symptoms a family member or another person has observed. To help a medical professional diagnose and treat epilepsy, it is beneficial if a loved one writes down observations or records an actual seizure in progress. It can be life-saving for family members to know first aid steps for seizures. To minimize the frequency of symptoms, encourage older adults to seek treatment as soon as possible and take medications as directed. Over time, some patients experience complete relief from symptoms.

For more information on epilepsy among elderly; see this document by Epilepsy South Africa.

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