Symptoms and EEG Findings of Elderly Epilepsy in Memory Clinic

Kazumasa Shiozaki

Department of Psychiatric Rehabilitation, Yokohama Comprehensive Care Continuum

In Japan, the population is rapidly aging, and dementia is increasing.  The incidence of epilepsy is also increased in the elderly, however, this is not well known.
Epilepsy in the elderly, symptoms are often similar to dementia, and a patient with epilepsy often visited a memory clinic.  Epilepsy in the elderly has different characteristics from epilepsy in adulthood.  There is a high proportion of symptomatic epilepsy.  Frequency of convulsive seizure is low, on the other hand, complex partial seizures are more frequent.
Seizure symptoms are various, impaired consciousness, automatism, decline in cognitive function and memory, hallucinations, autonomic symptoms, topographical disorientation and epileptic aphasia.
Epilepsy in the elderly, compared to the adulthood, impaired consciousness is sometimes unclear, automatism is relatively rare, and prolonged twilight state after the attack.
Also in interictal, the patients often sustained a mild cognitive decline and also had epileptiform discharges appear most likely in the temporal lobe in EEG.
Epilepsy in the elderly, respond well to anti-epileptic drug therapy.  In the memory clinic, it is important to distinguish the epilepsy in the elderly from dementia.

Address correspondence to Dr. Kazumasa Shiozaki, Department of Psychiatric Rehabilitation, Yokohama Comprehensive Care Continuum (1735 Toriyama-cho, Kouhoku-ku, Yokohama 222-0035, Japan)