Epilepsy And Aging

Overview

Epilepsy is a brain condition that causes a person to have repeated seizures. A seizure is a sudden burst of electrical activity in the brain. It can change how a person feels, moves, behaves, or remembers things for a short time. Not every seizure means a person has epilepsy. Epilepsy can start at any age, including later in life, and aging can change how seizures look and how they are managed.

Yes. Seizures and epilepsy are seen more often in older adults than many people realize. Some older adults have had epilepsy for years, while others have their first seizure later in life.

It can affect anyone, but it is more likely in older adults who have had a stroke, a head injury, a brain infection, memory problems such as dementia, or who take several medicines. It can also happen with no clear cause.

Symptoms

Common symptoms

• Brief confusion or staring spells where the person seems ‘not quite there’
• Unusual feelings, smells, tastes, or a sense of déjà vu
• Sudden jerking or stiffening of part or all of the body
• Falling or dropping things for no clear reason
• Losing awareness for a short time and not remembering it afterwards
• Feeling very tired, confused, or sleepy after a seizure
• Tongue biting, loss of bladder control, or injury during a seizure

Symptoms in older adults

• New confusion or memory lapses that come and go
• Falls or near-falls with no clear cause
• Brief periods of not responding or being ‘switched off’
• Strange sensations, dizziness, or visual changes
• Seizures that are harder to notice because they look like age-related confusion
• More risk of injury or longer recovery because of other health conditions

Causes

Main causes

• Stroke — a leading cause of new seizures in older adults
• Head injury or brain injury
• Brain tumors or growths
• Brain infections such as meningitis or encephalitis
• Memory and brain conditions such as Alzheimer’s disease or other dementias
• Genetic factors that affect brain activity
• Unknown cause — sometimes no clear reason is found

Risk factors

• Increasing age
• Previous stroke or heart disease
• Head injury
• Family history of epilepsy
• Memory problems or dementia
• Alcohol withdrawal or heavy alcohol use
• Missed epilepsy medicines or sudden stopping of medicines
• Lack of sleep, dehydration, or illness
• Taking several medicines that may interact with each other

When to see a doctor

See a doctor urgently if:

• You or someone else has a first seizure
• Seizures become more frequent, longer, or different from usual
• You have a fall, injury, or confusion that might be linked to a seizure
• You notice new memory or thinking problems that worry you
• You have side effects from epilepsy medicine that are upsetting or getting worse

Book a routine appointment if:

• You want to review your epilepsy medicine or ask about interactions with other medicines
• You are worried about driving, work, living alone, or home safety
• You have questions about bone health, falls, or memory
• You feel low, anxious, or isolated because of epilepsy
• You want to make a seizure action plan with your care team

Diagnosis

A doctor will ask what happened before, during, and after the seizure. They will want to hear from someone who saw it if possible. They will review your health history, medicines, and any other conditions. They may refer you to a specialist, such as a neurologist or an epilepsy nurse. The aim is to find out whether it was a seizure, what type it was, and what may have caused it.

Tests that may be done

• Blood tests to check for infections, salt balance, blood sugar, and other causes
• EEG (electroencephalogram) — a painless test that records brain waves
• Brain scan such as CT or MRI to look for stroke, injury, or other brain changes
• Heart tests, because some heart rhythms can cause fainting that looks like a seizure
• Memory and thinking tests if confusion or memory problems are part of the picture
• A review of all your medicines, including ones bought without a prescription

What to expect at your appointment

You may be seen by a specialist team. They may ask you to keep a seizure diary and to bring someone who has seen your seizures. You may be given safety advice while tests are arranged. Driving rules can vary, so ask your doctor or local driving authority what applies to you.

Treatment

Treatment aims to control seizures, keep you safe, and protect your quality of life. In older adults, care also focuses on avoiding medicine interactions, preventing falls, and checking memory and bone health. Your care team will tailor a plan to your seizure type, other health conditions, and daily needs.

Self-care at home

• Take epilepsy medicine exactly as prescribed, and do not stop it suddenly without medical advice
• Keep a simple seizure diary with dates, times, triggers, and how you felt
• Get regular sleep and avoid becoming very tired or dehydrated
• Ask your pharmacist or doctor to review all medicines, including supplements, for interactions
• Make your home safer to reduce fall and injury risk, such as using night lights and removing loose rugs
• Tell family, friends, or carers what to do if you have a seizure
• Avoid swimming alone, bathing alone if seizures are not controlled, and cooking alone near hot surfaces when risk is high

Medical treatments

Most people with epilepsy take antiseizure medicine. Your clinician will choose a medicine based on your seizure type, age, other health conditions, and other medicines you take. Treatment is usually started at a low dose and adjusted slowly. Regular reviews and blood tests may be used to check for side effects and interactions. Some people need a rescue plan for long or repeated seizures. Never change or stop epilepsy medicine without speaking to your care team. Other options, such as surgery or special diets, are considered only for selected people.

When is surgery considered?

Surgery may be an option for some people whose seizures do not respond well to medicine and who have a clear seizure focus in the brain. It is considered carefully by a specialist team, especially in older adults who may have other health conditions.

Living with this condition

Living with epilepsy as an older adult often means planning ahead. Keep medicines organized, make your home safer, and let people close to you know how to help. Regular reviews can catch medicine problems early. You may need to adjust driving, bathing, cooking, or exercise habits for safety, but many people still live full and active lives.

Lifestyle tips

• Keep a regular sleep routine
• Limit alcohol and avoid binge drinking
• Stay physically active in a safe way
• Eat regular meals and stay hydrated
• Avoid known triggers such as missed medicines or severe stress where possible
• Use a pill organizer or reminders if memory is a concern
• Have a seizure action plan that family or carers can follow

Diet and exercise

A balanced diet and regular movement are good for general health, mood, and sleep. Choose activities that match your balance and health needs, such as walking, swimming with a buddy, or chair-based exercise. Ask your care team about fall prevention and bone health, especially if you have taken epilepsy medicine for a long time. There is no need to follow a special ‘epilepsy diet’ unless a specialist recommends it.

Mental health and emotional wellbeing

Epilepsy can cause worry, low mood, or loneliness, especially if seizures change your independence. These feelings are common and treatable. Talk to your doctor or nurse if you feel anxious, depressed, or overwhelmed. If you feel unsafe or in crisis, contact your local emergency services or a local crisis support service straight away.

Prevention

Not all epilepsy can be prevented, but some risks can be lowered. Managing blood pressure, heart health, and diabetes helps reduce stroke risk. Preventing head injuries, treating infections promptly, avoiding heavy alcohol use, and taking medicines as prescribed can also help. If you already have epilepsy, regular reviews and good sleep can reduce the chance of seizures.

Vaccines

Keep up with routine vaccines as advised by your healthcare provider. No vaccine prevents epilepsy, but preventing serious infections is part of general brain and body health.

Screening programmes

There is no general screening test for epilepsy. Regular checks of blood pressure, heart health, diabetes, memory, and medicines can help. If you take epilepsy medicine long term, ask your care team whether you need bone health checks.

Complications

If left untreated

• More seizures or longer seizures
• Falls, fractures, and other injuries
• Confusion, memory problems, or trouble thinking clearly
• Depression, anxiety, and social isolation
• Medicine side effects or harmful interactions with other medicines
• Driving restrictions and loss of independence
• A rare but serious emergency called status epilepticus, where seizures do not stop

Long-term outlook

Many older adults with epilepsy can get good seizure control and stay independent with the right care. New seizures in later life are often manageable once the cause is checked and treatment is reviewed. Regular follow-up, safety planning, and support can help you live well.

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