Epilepsy is a condition affecting the brain and nervous system. It is usually diagnosed after someone has had more than one seizure episode. However, it's crucial to note that not all seizures happen because of epilepsy. One in every four people newly diagnosed with epilepsy is over 65, which means one in 67 older adults has epilepsy, and this number is constantly increasing. In addition, understanding the signs of epilepsy can take time and may require many tests.
However, epilepsy is one of the most common nervous system diseases in older adults after dementia and strokes. Therefore, there is a risk of the condition going undiagnosed if the signs of epilepsy are not correctly understood in the elderly.
What causes seizures in the elderly for the first time?
Seizures in the elderly often occur due to a particular trauma or condition and are not always associated with epilepsy. Elderly epileptic attacks are different from attacks occurring in childhood.
Likely reasons for elderly seizures include:
Infection in the Central Nervous System
The Central Nervous System often gets infected due to viruses, bacteria, or parasites triggering seizures, also causing infection in brain tissue, leading to abnormal activities in the brain's electrical activity.
Brain tumour
Elderly seizures can be one of the early symptoms of a brain tumour. As the tumour grows, the attacks become worse or begin reoccurring. Different tumours can induce seizure attacks in various forms, typically due to bleeding or stress on the brain.
Drug use and withdrawal
Several drugs, such as antipsychotics and antidepressants, can bring about seizures in older adults. These substances cause seizures by varying neurotransmitter activity or creating a sedative effect on the brain.
Trauma-causing brain injury
Seizures might begin right after a trauma-causing brain injury or occur several hours, days, or months afterwards. In addition, the injury might result in inflammation or damage to the brain tissue, which might further trigger seizures.
Stroke
Stroke and cerebrovascular diseases account for 30% - 50% of elderly epilepsy-identified cases. Studies have also reported that a stroke accounts for 45% of elderly epilepsy cases over 60.
A stroke happens when the brain's blood vessel erupts or gets blocked, interrupting blood flow to the brain, which damages the tissue. The injury can change the brain's electrical activity, resulting in a post-stroke seizure.
How to tell if your older relatives have epilepsy?
It's not always easy to spot the signs of epilepsy in later life as seizures are difficult to recognise in older people. This is because some of the most common symptoms of seizures, such as falls, memory issues, numbness, and dizziness, are associated with old age. Moreover, many different types of seizures result in varying signs and symptoms.
Often, a person having an attack may exhibit the following symptoms:
Unusual movements like repetitive hand jerking or lip smacking
Sometimes a person might be making natural automatic movements like fumbling with their hands, rubbing their fingers together, or fidgeting with their collar or buttons. These movements last less than a minute and might get identified as nervous tics. If these movements occur frequently, a doctor should be consulted to rule out epileptic seizures.
Frequent unexplained falls or blacking out
With age, having falls due to frailty is a common occurrence. However, if the falls become too frequent, your elderly relatives should consult a GP immediately. Falls can be associated with a brain or heart issue, such as a brain tumour, narrowing of a blood vessel in the brain, or an irregular heartbeat. But if the falls are associated with epilepsy, issues such as these will not be present.
Recurrent state of confusion, word loss, or memory loss
After a seizure, older adults go through a postictal period. This period begins after a seizure subsides until the person returns to baseline. The postictal phase typically lasts between 5 and 30 minutes, but this period lasts longer in older adults than younger people. While going through this period, people might lose their memory or become dazed. Missing large chunks of time or forgetting things can also be linked to dementia. However, tests like an ECG can help determine if epilepsy is behind the forgetfulness.
Convulsions
Similar to younger adults, older people might go through convulsive seizures. Therefore, it's always crucial to contact 999 if you notice your elderly relatives having convulsions, as these can indicate a critical condition such as a stroke or bleeding in the brain.
Many conditions could be causing these symptoms in your elderly relatives. Still, if you notice a repeating pattern of symptoms, they can be signs of epileptic seizures, and you should be sure to consult a GP or a neurologist to rule out other illnesses.
Seizures happen in many varied forms. For example, during convulsions (tonic-clonic seizures), a person might lose consciousness and fall on the floor as both halves of their brain get impacted by electrical activity. Other episodes, such as focal seizures, might cause symptoms such as memory loss or confusion. Older adults with epilepsy typically have focal seizures, which might turn into a tonic-clonic seizure.
What to do if an older adult has an epileptic seizure?
Seeing your elderly relative go through an epileptic seizure can be scary, but there are a few simple things that you can follow to help them.
- Put a cushion under their head if they are on the floor.
- Only move them if they are in a dangerous situation, like near a busy road.
- Remove any tight clothing around their neck, such as a tie or buttoned collar.
- Once the convulsions stop, turn them on their side or in a recovery position.
- Talk to them calmly until they recover, as they might feel confused.
- Note down the timing for the start and end of the seizure.
- Do not give them any food or drink until they completely recover.
- Call an ambulance if the seizures last more than 5 minutes or if your elderly relative has an episode for the first time.
Older adults who have epilepsy may have a care or emergency plan with their GP in case of an episode. If you are aware of this plan, you can act accordingly.
What kind of treatment is available for older adults newly diagnosed with epilepsy?
Older adults that develop epilepsy can have a difficult time managing it. Epileptic medicines can control epilepsy; studies show, for 5 in every ten people with epilepsy, the first epilepsy medicine they try will stop their seizures. Some people have to take two or more different medications for epilepsy depending on their age and the type of seizures they get.
However, eight in ten adults over 65 or older have more than one chronic illness, and it can be challenging to balance the intake of these medicines with epilepsy remedies. Epilepsy pills need to be taken every day, precisely as prescribed. It's significant not to stop taking them without medical guidance, as this could cause more seizures.
How can family and loved ones support an older adult with epilepsy?
Being diagnosed with epilepsy can bring different emotions to your elderly relatives, so it's crucial to extend support and try to understand how epilepsy might affect their later life. Of course, many people live a full life after being diagnosed, however, there are a few things that should be considered;
- Driving regulations are in place for people who have had seizures. People who are not allowed to drive due to epilepsy have access to free bus travel in England, Wales, and Scotland or half-price travel in Northern Ireland.
- If your elderly relative is still employed, then depending on the type of employment and the type of seizures, your elderly relatives get, they might need accommodations to be made at their workplace.
- Older adults with epilepsy shouldn't take baths without someone present to check if they are safe. A momentary lapse in consciousness can be fatal. While epilepsy is manageable, it can make swimming alone, climbing stairs, and using heavy machinery dangerous.
There are different types of alarms for different types of seizures. Some are set off when someone falls into an episode or has a convulsive episode in bed. Others can be set off using an SOS button that your elderly relatives can press themselves if they feel a seizure coming on or in any other emergency.
Whilst a panic alarm will not prevent an epileptic episode, it can help your elderly loved one to get assistance quickly and easily in the possibility of one occurring. Our personal fall alarms include fall detection technology, so an alert will be raised if a fall is detected, even if the button isn't pressed.
We offer various panic alarms to suit different lifestyles and circumstances. All our alarms are connected 24/7 to our award-winning Emergency Resolution team.
