Diagnosis
The diagnosis of epilepsy tends to be more challenging than for younger patients for several reasons
• Elderly individuals are more likely to have less clinically dramatic seizures, such as episodes of blank staring, than clinically obvious generalized tonic clonic seizures. Staring episodes might be dismissed by the patient or caretaker as “senior moments” and ignored.
• Elderly individuals with dementia might have communication issues and will not be able to describe symptoms to their caretakers
• Elderly individuals are more likely to be socially isolated. As a result, nobody might ever see the seizures, or the patient might not be able to seek proper care.
• Misdiagnosis of epilepsy is also common in the epilepsy. Periods of confusion or loss of consciousness related to other medical conditions, such as infectious conditions or heart disease, maybe inappropriately attributed to epilepsy before appropriate testing is performed. Over-prescription of seizure medication, especially in nursing homes, is very common, and can cause serious problems.
• The elderly may have transportation issues which might prevent them to getting proper tests and then treatment.
• Mood symptoms such as depression and anxiety, which frequently occur with epilepsy and affect quality of life, are harder to diagnosis in this population