Late-onset epilepsy: peculiarities of diagnostics and treatment

February 24, 2021

The increase in the incidence of epilepsy in the elderly is due to increased life expectancy and improved diagnostics of epileptic seizures in the elderly. The aim of the work was to study the data of modern scientific literature on the features of the etiology, clinical picture, diagnostics and treatment of late-onset epilepsy in the elderly. The etiological factors of late-onset epilepsy, the role of risk factors for cerebrovascular diseases, which simultaneously can lead to the development of late-onset epilepsy, are being discussed. The possibility of late-onset epilepsy appearance due to cerebral disease of small vessels in the unknown etiology of epilepsy and the lack of clear structural changes on magnetic resonance imaging is considered. The comorbidity of late-onset with dementias is being discussed. The peculiarities of the phenomenology of epileptic seizures in the elderly and the value of the electroencephalography, which often does not detect epileptiform disorders, are presented. A clinical case of difficulties in the diagnosis of late-onset epilepsy is given. New-generation antiepileptic drugs with relatively few drug interactions, but at the same time with the least effect on patients’ cognitive functions, such as lamotrigine, levetiracetam, and gabapentin are recommended for the treatment of late-onset epilepsy.


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