28 Oct21

6 Signs of Epilepsy in Older Adults

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According to the CDC, epilepsy is the third most common neurological condition affecting older adults. Epilepsy is the third most common neurological disorder affecting older adults after stroke and dementia, and the incidence of epilepsy is increasing rapidly in this population.

The signs of epilepsy in older adults can be different than they present in the younger population. Usually, people co-relate epilepsy with tonic-clonic seizures or grand-mal seizures, which include stiffening of the body, uncontrolled movements of the limbs (convulsions) and loss of consciousness. However, epilepsy presents itself slightly differently in older adults. Therefore, it is important to distinguish the signs that someone is living with epilepsy as opposed to other seizure-related conditions, as the signs can be far more subtle and are easier to miss. When untreated, epilepsy has been shown to lead to cognitive decline. 

Here, are six important signs that an older adult in your life may be having an epileptic seizure:

1. Repetitive Hand Movements, Lip-smacking or Jerking.

Try noticing early signs that involve repetition. For example, fidgeting with clothing/an object or fumbling with hands. These actions, called automatisms, tend to look so normal that they are often ignored. What makes these seemingly normal actions appear to be a sign of epilepsy is the repetition. These actions can be repeated for up to a minute, and they are commonly written off as nervousness. However, if you notice an elder in your family do this often over a period of a few months, consult your doctor. Lip-smacking and mild jerking of a part of the body can also be early signs of epilepsy in senior citizens.

2. Memory Loss or an Episode taking place more than once. 

The time period after a seizure is called the postictal period. It is more prevalent in older adults than in younger people. While for younger people, the postictal period can range from a few seconds to minutes, for the elderly, it could last hours or even days. You’ll notice them usually staring into space looking confused, and usually with no memory of what just occurred. If you notice a loved one is forgetting things too often, even events that may have just taken place, talk to their doctor, especially if you see a repetition of these episodes.

3. Being Confused Often 

Notice behavioural changes, such as an outgoing person becoming very withdrawn or acting strangely. It’s easy to disregard this as someone having an ‘off’ day, since all of us don’t feel like ourselves all the time. If you notice a loved one acting quiet, lost or strange often, verging on being disinterested or even depressed, before going back to their normal selves, it is a cause of concern. 

4. Sudden, uncontrolled falls

Falls are always a concern with elders, especially when it happens in an uncontrolled space. Symptoms such as breathlessness, palpitations or dizziness would be seen in a case related to a heart or brain issue. If your loved one suffers from such episodes, then it’s the best thing to contact a doctor right away.

5. Convulsions

There are two peak periods during which one is likely to have an onset of epilepsy: one occurs in childhood and the other after the age of 65. Just like the younger generation suffers from convulsions when living with epilepsy, older adults do the same. Immediately call your emergency contact number if you notice someone convulsing. This could be a life-threatening condition for the patient and could lead to a stroke, thus requiring immediate medical attention.

6. Impairment of Language Processing 

Another sign of epilepsy in older adults is their inability to “find the right words” when having a conversation. This is a frequent sign of partial complex seizures. That ‘tip-of-the-tongue’ feeling of being unable to come up with a word on cue, yet being able to convey some information about the word – such as what letter it starts with or what it rhymes with – is a sign to watch out for. Epilepsy that arises in the temporal lobe will affect structures near the inner surface of the lobe, causing a more basic disturbance of word retrieval.

According to the Epilepsy Foundation, over 570,000 people aged 65 and older have epilepsy, and the elderly are the fastest growing population to be affected by the disease. Diagnosing epilepsy in older adults isn’t easy, because seizure symptoms in this population may be misinterpreted and attributed to another condition.

Older adults who are at risk of developing epilepsy include

  1. Those with a history of a brain injury or concussions such as Veterans
  2. Those who have had a stroke, brain tumor or brain aneurysm in the past
  3. Those with a family history of seizures

You can find more information on what to do when someone is having a seizure here. Also read our blog post on how to remember to take your epilepsy medication on time.