Background: Acute symptomatic seizures and epileptic disorders are frequent health problems of elderly patients. An early and reliable distinction of the seizure etiology is important to ensure adequate treatment, and to prevent unwarranted diagnostic and therapeutic procedures.
Methods: We review the current literature based on a MEDLINE search, describe age-related problems in detail, with particular attention to clinical practice, discuss possible criteria and potential pitfalls for diagnostics, and provide a compilation of etiologic factors for acute symptomatic seizures.
Results: The most common causes of acute symptomatic seizures - acute cerebrovascular disorders, metabolic disorders, traumatic brain injury, meningo-encephalitis, cerebral tumors, and withdrawal of alcohol and other central agents - are well-defined and seem to permit straightforward diagnostic and therapeutic strategies. The current classification of seizures and epileptic syndromes apparently provides clear definitions. However, multiple age-related risk factors, as well as a reduced discriminatory power of clinical and technical diagnostic criteria can make the distinction difficult.
Conclusion: Typical age-related problems are incomplete or missing medical history, dementia, oligosymptomatic seizures, inconclusive EEG and cerebral imaging results, multiple pathological findings and comorbidity with ambiguous significance, confounding sleep disorders, intake of proconvulsive drugs, and psychogenic seizures. All diagnostic and therapeutic decisions need to be based on an integrative and individual approach that includes diagnostic findings and risk factors, the intake of medications and other agents, and the social situation of the elderly patient.
Keywords: New onset epilepsy, old age epilepsy, acute symptomatic seizures, provoked seizures, neurogeriatrics, epileptogenic drugs, dementia.
The Role of Endothelin-1 in Obstructive Sleep Apnea Syndrome and Pulmonary Arterial Hypertension: Pathogenesis and Endothelin-1 Antagonists
Current Medicinal Chemistry Gene Therapy in Cerebrovascular Diseases
Current Gene Therapy Cystatin C in Cerebrovascular Disorders
Current Neurovascular Research Genetic Risk Factors in Cerebrovascular Disorders and Cognitive Deterioration
Current Genomics Role of Renin Angiotensin System Inhibitors in Cardiovascular and Renal Protection: A Lesson from Clinical Trials
Current Pharmaceutical Design Pathophysiology of the Vascular Wall and its Relevance for Cerebrovascular Disorders in Aged Rodents
Current Neurovascular Research Prevention of Cardiovascular Diseases with Anti-Inflammatory and Anti- Oxidant Nutraceuticals and Herbal Products: An Overview of Pre-Clinical and Clinical Studies
Recent Patents on Inflammation & Allergy Drug Discovery Commentary [Research Highlights : Neurotrophic Factor Treatment of Neurological Disorders: The Benefits of a Pleiotropic Treatment Approach]
CNS & Neurological Disorders - Drug Targets Mean Platelet Volume: A Link Between Thrombosis and Inflammation?
Current Pharmaceutical Design Endocannabinoid Regulation of Matrix Metalloproteinases: Implications in Ischemic Stroke
Cardiovascular & Hematological Agents in Medicinal Chemistry Evaluation of Common Unfavourable Genetic Variants in Cerebrovascular Diseases: Recommendation for Supportive Genetic Examinations and Methodological Approaches for Common Genetic Variants
Current Medicinal Chemistry Neuroprotection by Diazoxide in Animal Models for Cerebrovascular Disorders
Vascular Disease Prevention Neurological Disorders in Pregnancy
Current Women`s Health Reviews Patient-Specific Modeling and Multi-Scale Blood Simulation for Computational Hemodynamic Study on the Human Cerebrovascular System
Current Pharmaceutical Biotechnology Role of Diagnostic Ultrasound in Patient Selection for Stroke Intervention
Recent Patents on CNS Drug Discovery (Discontinued)