Epilepsy in the elderly: Some clinical and pharmacotherapeutic aspects

The majority of epileptic seizures and epilepsies are no longer manifested in childhood and adolescence; instead their incidence is higher at the age of 65 years or older than during the first two decades of life. After cereb rovascular disorders and dementias, epileptic seizures and epilepsies now c onstitute the third most frequent neurologic problem encountered in the eld erly. Important clinical features of epilepsy in the elderly related to the diagnosis include the most common seizure types and causes. Special featur es of drug treatment for epilepsy in the elderly result not only from the p hysiologic changes in the elderly but also from the particular pharmacology of the respective drugs. Because elderly patients very often require other long-term medication in addition to antiepileptic therapy, drug interactio ns between different antiepileptic drugs and between antiepileptics and oth er drugs can be of major significance. Other special features of pharmacoth erapy for epilepsy in the elderly include the presence of liver and kidney diseases.