Management of seizures in the elderly

The elderly are a substantial and rapidly increasing proportion of the popu lation. They also have a high frequency of seizures, which can lead to seri ous consequences. The elderly differ from the young in that they may have m any medical conditions, take numerous concomitant drugs, have different met abolic characteristics, and are more likely to suffer from neurologic condi tions such as stroke. The elderly are also more sensitive to adverse effect s of prescription drugs. As available antiepileptic drugs (AEDs) have rough ly equivalent efficacy, side-effect profiles are a major determinant in cha rting therapy. The older AEDs have a well-known collection of undesirable s ide effects. Newer AEDs have potential advantages for the elderly, particul arly with respect to tolerability. The characteristics of seizures in the e lderly and guidelines for their treatment are discussed.