There are many reasons why seizures in older people go unrecognized or are misdiagnosed as dementia.
When the astute, gregarious 74-year-old Jack didn’t remember attending the May wedding of his favorite granddaughter, Anne, they both realized something was wrong. As we sat in my office recently, he showed me a picture of her in her bridal gown.
I asked them about his behavior and how he came to see an epileptologist (a neurologist with additional training in treating epilepsy) at a geriatric clinic.
Jack reported that he regularly had days where he was not himself, and that he was much quieter than usual, almost confused.
Over the past year, Jack regularly reported having days that weren’t him, much quieter than usual, and almost confused. There were days when he couldn’t remember the details.
Feeling very anxious, they sought medical advice, starting with a primary care provider who sent them to a general neurologist in the area. was diagnosed.
Still, his confusion was temporary, and he was “sharp as a tack” between these episodes, so he wasn’t convinced.
They sought a second opinion from a neurologist in another area. He repeated his initial lab work and imaging of his brain and came to the same conclusion. Later, at a hair salon appointment, Anne learned that her hairdresser’s mother had attended my clinic.
After listening to him and sorting out his symptoms, I admitted him to an epilepsy monitoring unit. was recorded and identified.
It was what neurologists call verbal automatism, a common symptom of seizures arising from, among other things, the temporal lobe, the region of the brain that makes memories. I was relieved.
“But I thought young people were having seizures,” his granddaughter said after I relayed the diagnosis. . One in four of her newly diagnosed people with epilepsy is over the age of 65.
However, the idea that epilepsy is a disease of the young has permeated not only society at large, but also the medical community.
The idea that epilepsy is a disease of the young is pervasive not only in society at large, but also in the medical community.
Jack is doing well on relatively low doses of a single anti-epileptic drug.
While the path to an accurate diagnosis in this patient was relatively rapid, accurate diagnosis in older people can be delayed by up to about two and a half years.
There are many reasons why seizures in older people go unrecognized or are misdiagnosed as dementia.
Seizures in older people are less dramatic than in younger people. Instead, they tend to be very subtle, often featuring simple behaviors or confusions that are easily missed or explained.
This older age group has a long list of seizure mimics, including heart problems and dementia-induced mild strokes and fainting. The medical literature documents memory and mental decline in older people who have frequent seizures.
Nevertheless, it has also been shown that lost cognitive abilities can be regained by controlling seizures. Epilepsy in the elderly is a treatable cause of dementia.
Further research is needed to fully understand this relationship. Additionally, more patients, clinicians, and health care providers should be aware of seizures in the elderly. Currently, about 1 million adults in the United States over the age of 55 have active epilepsy.
This number will only increase as the fastest growing demographic is those over 65.
Without more awareness, more people may have their symptoms misunderstood or untreated.
Additionally, age is a consideration for candidates in the midterm elections and will also participate in the 2024 presidential election. But Medicare spending in 2020 will hit her $829.5 billion, and despite huge spending on health care after age 65, life expectancy in the United States is only her 42nd in the world.
To improve the health status of this age group, policy makers, funders, research institutions, and families need to address the need to invest in epilepsy and dementia.
Treating seizures can improve the quality of life for individuals and their families. Reduce healthcare costs through fewer emergency room visits for unnecessary brain scans and lab work, fewer medications, doctor visits, hospital stays, and more time living independently. .
In Jack’s case, if he didn’t get medical attention, his memory would continue to decline and he might have had to move to welfare. may have been transported to
However, since he was diagnosed, he is on medication twice a day and is living a healthy, active life independently.
As more Americans get older, all concerned must be aware of the concerns about memory as a diagnosis and the possibility of epilepsy. , symptoms may or may not be treated.
The future looks much brighter with increased awareness of dealing with accurate diagnoses.
