Strategies for successful management of older patients with seizures

The incidence of seizures increases dramatically with age, making epilepsy in the older patient a common clinical presentation in the primary care pra ctice. In the case of a single seizure or when the underlying cause can be corrected antiepileptic drug (AED) therapy may not be warranted. For recurr ent seizures, single AED therapy should be initiated at a low dose and grad ually titrated upward. Control of seizure frequency is dependent on appropr iate AED selection and compliance, drug-drug interactions, and minimization of side effects. Monitoring of AED serum levels is imperative for effectiv e AED therapy Conventional AEDs remain the standard anticonvulsants for epi lepsy in older patients. The neuter AEDs have demonstrated efficacy as adju nctive therapy and may offer reduced side-effect profiles and fewer drug-dr ug interactions.