Epilepsy in Later Life

The incidence of seizures and epilepsy increases after the age of 65 years. With a rise in the number of older people, clinicians and healthcare systems will be confronted with the prospect of managing an increasing number of older individuals with epilepsy. There are specific diagnostic challenges because of atypical presentations, a wide range of differential diagnoses, and management challenges because of comorbidities, a higher incidence of cognitive impairment, and increasing frailty. Pharmacotherapy is the mainstay of treatment. In general, there is a good prognosis for seizure control, although tolerability, age-related changes in pharmacokinetics, and polypharmacy with drug–drug interactions are important considerations.