Seizures - Epilepsy Foundation Northwest

Seizuresin Later LifeSeizuresin Later Life

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About the Epilepsy Foundation

The Foundation’s mission is to ensure that people with

epilepsy have access to all life experiences and to prevent,

control and cure epilepsy through research, education,

advocacy and services.

The Foundation offers information and assistance to

people of all ages who are living with epilepsy, and their

families, through its Epilepsy Resource Center.

The Epilepsy Foundation’s H.O.P.E. (Helping Other People

with Epilepsy) Mentoring Program offers mentoring and

presentations on epilepsy to individuals, families and in

community living settings.

To find out more about the H.O.P.E. Mentoring Program or

the name of a participating Epilepsy Foundation near you,

call 877-467-3496, or visit www.epilepsyfoundation.org

This pamphlet provides general information about epilepsy to the

public. It is not medical advice. People with epilepsy should not

make changes in treatment or activities based on this information

without first consulting a physician.

© 2003,2009 Epilepsy Foundation of America, Inc.


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Mrs. Smith hadjust celebratedher 65th birthdaywhen her sonnoticed some-thing was notright. She wouldstop her crochetwork for a fewseconds and stareblankly ahead.Mrs. Smith didnot respond whenhe called her.Then, suddenly,she was aware ofher surroundingsagain. Mrs. Smithsaid, “I don’tknow whathappened justnow. What was Idoing?”

Seizures in Later LifeWhen people in their sixties, seventies or eighties experience unusual feelings—lost time,suspended awareness, confusion—it’s easy toassume that it’s just part of getting older.

But there may be another explanation.

Those unusual feelings may be caused by briefseizures, and the people experiencing them mayhave joined over 500,000 American seniorswith epilepsy.

People tend to think of epilepsy (also called aseizure disorder) as a condition that happensmost often in childhood. But studies show thatrisks of developing epilepsy increase after theage of 60.

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Older people face special challenges in livingwith and adjusting to epilepsy and seizures. Thispamphlet will explore some of those issues and,we hope, offer information that will be helpful toseniors living with seizures and those who careabout them.

About EpilepsyEpilepsy is a disorder of the brain, a kind ofoccasional glitch in the amazing electrical systemwhich controls everything we feel and do.

These brief malfunctions(called seizures) may for ashort time block a person’sawareness of time and place.Or they may cause uncontrol-lable shaking, convulsions,confusion, odd sensations orsudden changes of mood.

Anyone at any age can have a seizure if thebrain is stressed sufficiently by injury ordisease. A single seizure isn’t epilepsy, althoughthe symptoms are the same.

• Changes in vision and hearing• Odd feelings• Staring• Déjà vu (sense of things having happened before)

• Jamais vu (familiar things suddenly seem unfamiliar)

• Trembling that moves up one side of the body

SIMPLE PARTIAL SEIZURES

• Lip smacking• Swallowing• Picking at clothes• Disrobing• Wandering• Lost time• Lack of response to others

COMPLEX PARTIAL SEIZURES

CommonSymptoms

Epilepsy is thename given toseizures that occurmore than oncebecause of anunderlying condi-tion in the brain.

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Types of SeizuresThe kind of seizure a person has depends onwhere the electrical disturbance takes placeand how much of the brain is affected. It ispossible to have just one type of seizure, ormore than one type.

PARTIAL SEIZURESIn partial seizures, the electricaldisturbance is limited to a specificarea of one side of the brain.

Partial seizures are the mostcommon type of seizure experienced by people withepilepsy. Almost any move-ment, sensation, or emotioncan happen as part of a partialseizure. Partial seizures can be simple (duringwhich a person remains awake and aware) orcomplex (during which awareness is clouded).

Simple partial seizures may affect speech,movement, and sensations. People may see,hear, feel things that are not really there, orexperience shaking or sudden anger or fear.

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• Senseless, clumsymovements

• Repeated phrases• Unaware of danger or pain

• Loss of awareness

L SEIZURES GENERALIZED SEIZURES

• Convulsions• Sudden falls• Brief blackouts, staring• Sudden muscle jerks

Sometimes a firstseizure is a symp-tom of an unrelatedhealth problem thatmay need immedi-ate attention. Asenior or his familymember should letthe doctor knowabout a first seizureto rule out otherconditions as a possible cause.

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Complex partial seizures often occur in areasof the brain involving consciousness ormemory. People having this kind of seizurecan’t interact normally with things or otherpeople around them during the seizure.

They appear unaware of their surroundings andmay injure themselves as a result. They usually willnot remember what happened during the episode.

GENERALIZED SEIZURESGeneralized seizures happen when waves ofelectrical activity swamp the whole brain at once.

Generalized tonic-clonic (grand mal) seizuresOften start with a cry, caused by air beingforced out of the lungs. The person slumps inplace or falls to the ground, unconscious. Thebody stiffens briefly and then begins to jerk.

The tongue may be bitten. A frothy saliva mayappear around the mouth. Breathing may bevery shallow and even stop for a few moments.

Sometimes the skin turns a bluish color becausebreathing may be briefly interrupted and theblood doesn’t get as much oxygen as usual.

After a minute or two, the jerking movementsslow down and the seizure ends naturally.Bladder or bowel control may be lost as thebody relaxes after the seizure. Consciousnesswill then slowly return.

Sometimes people have a warning before aseizure, or a special feeling that tells them aseizure is going to happen. Sometimes thewarning gives people enough time to get to asafe place before they lose consciousness.The warning feeling is called an aura.

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Seizure First AidSeeing a seizure for the first time can be frightening. People wonder what to do and how to help.

FIRST AID FOR CONVULSIONS (GRAND MAL,GENERALIZED TONIC-CLONIC SEIZURES)• Ease the person having the seizure down to the floor or onto a flat surface.

• Put something soft and flat under the head.

• Turn him gently onto one side to preventchoking and keep the airway clear.

• If the person having the seizure is seated,turn his head gently to one side so anyfluids can drain away from the mouth.

“The first time Isaw my grand -father have aconvulsion I was at the seniorcenter. When hefell to the floor, Iwas scared. Luckilyan aide from thecenter knew whatto do to help him.Everything wasover in a matter ofminutes, but mygrandfatherneeded a long restperiod afterward.”


• Don’t try to forceanything into the mouth. Seizures do not cause people to swallow their tongue.

• Don’t try to give fluidsuntil the seizure iscompletely over and theperson is fully alert again.

• Don’t try to restrain the jerking move-ments. Muscles contract with force during seizures. Holding someone down during a seizure could cause tears in the muscle or even break a bone, especially in elderly people whose bones may be fragile.

FIRST AID FOR CONFUSION DURING OR AFTEROTHER TYPES OF SEIZURES• Remove anything from the area that might cause injury to someone who is temporarily unaware of where she is or what she is doing.

• Don’t try to restrain someone whois wandering and confused during a complex partial seizure. If danger threatens, block the person’s access to it or gently guide her away.

• Be reassuring, comforting and calm as awareness returns.

• Most seizures last only a couple of minutes and end safely without medical attention.

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Seizure first aidinvolves a fewcommon-sense steps toprotect an older personfrom harm.

What you should not do is just as importantas what you should do.


Signs to Watch ForSometimes, more serious problems develop.Here are a few ways to spot them:

• Time the Seizure. If a convulsion lastslonger than five minutes, or one seizurefollows right after another, call an ambulance. Non-stop seizures, calledstatus epilepticus, are dangerous forelderly people and prompt medical care is needed.

• Check for Injuries. Seniors who haveseizures may break bones, so special careshould be taken to find out if there is anyunusual pain after a seizure. Headachesare quite common, but a severe headacheafter a seizure in someone who doesn’tusually have them should be checked out.

• Track Awareness. If the person doesn’twake up after the seizure ends, call forhelp. While people are often confusedfollowing a seizure, confusion lasting morethan one hour after a seizure may signalthat the seizure is not over.

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Harry Spargo was70 years old. Hisarteries hadbecome narrowed,depriving parts ofhis brain of bloodand oxygen. Theresulting damageproduced seizures.He found it hardto believe hewould developepilepsy at thistime of his life.


STATUS EPILEPTICUSStatus epilepticus means a state of non-stopseizure or a series of seizures. Elderly peopleare more susceptible than younger people tohaving seizures that are hard to stop.

The episodes may be part of an existing seizuredisorder or be caused by some other seriousillness that affects the brain. Elderly peoplealso experience the highest rate of deaths dueto status episodes.

If you are caring for anelderly person with epilepsywho has prolonged seizuresor clusters of seizures, ask her to check with the doctorabout how these might

be treated and stopped at home, or ask thedoctor yourself.

New ways of giving medicine during a seizuremay bring the seizures to an end and preventepisodes of non-stop seizures.

CAUSES OF EPILEPSY When an elderly person has lived a long lifewithout a diagnosis of epilepsy and then develops the disorder, the first question isoften, “Why did this happen to me?”

Although in many cases, the answer is, “We don’t know,” seizures in older people may be caused by: • Stroke• Heart attack• Circulatory problems• Diseases affecting the brain• Brain tumor• Scarring from brain surgery

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Most seizures, even in seniors with otherhealth problems, endnaturally without anyspecial treatment.


Treating EpilepsyEpilepsy is usually treated with medication toprevent seizures.

The medicine, in the form of one or more anti-epileptic drugs, has to be taken every day, on time. Missing doses will make it morelikely that seizures will occur. People should be especially careful not to stop the medicationsuddenly. Stopping medication can causerebound seizures that could be life threatening.

Several drugs are used to treat epilepsy. Not allpeople respond to them in the same way. Someare more sensitive to side effects than others.Sometimes seizures continue even though themedication is being taken regularly.

In many ways, treatment of elderly people with epilepsy is similar to the way it is treatedin younger people.

However, there are some special issues whenan older person has a seizure disorder.

Medication, whether taken alone or in combi-nation with other drugs, is usually processed inthe body more slowly by the elderly than byyounger people.

A dose that a younger person can take withoutproblems may produce toxic effects in an olderperson. Levels of the drug in an older person’sblood may build up over time.

As a result, the elderly person may becomeconfused, irritable, and continually drowsy, all

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of which are conditions that can be easilymistaken for age-related problems.

Seniors may be takingmany medications forother health problemsbesides epilepsy, andthese may affect how wellthe epilepsy meds controltheir seizures.

On the other hand, theepilepsy meds may affectthe other medications thatan older person is taking.

It’s helpful if seniors tell their health care team, including their pharmacist, about all the medicines they are taking, including herbal products, nutritional supplements and vitamins.

Memory in elderly people may be impaired.Remembering when and how much medicationto take, especially when other medicines arebeing taken for other health conditions, can bea difficult task for an older person.

Taking too much or too little of an anti-epileptic medicine can increase the risk of side effects or seizures.

Keeping a medication calendar, or usingsegmented pill boxes marked by the day of the week, or using a device that will alertpeople when it’s time to take medicine canhelp seniors avoid missing doses or takingthem twice.

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When doctors are choosing a medicine for an older person, theylook at its effectivenessand safety, which isparticularly important inthe elderly. If a persondoes not walk well, forexample, the doctor maynot want to choose amedicine that makeshim unsteady.


Living with Epilepsy Although there are always exceptions, seniorcitizens with epilepsy who are otherwise in goodhealth and whose mental abilities are unaffectedcan usually continue to live independently.

Making certain changes in the home canreduce the risks associated with living alone.

• Living in a house or apartment that does not have stairs reduces the risk of injury from falls.

• Carpeted floors provide a softer surface if falls should occur.

• Padded furniture andprotective paddingaround the corners oftables help prevent injury.

• Using a microwave forcooking reduces the riskof burns and scaldsduring a seizure.

Technology is available to help older peoplekeep in touch with family members.

If seizures are fairly frequent, cell phones, beepers or wearable alarm devices give seniorsa way to call for help from any part of the house.

Some seniors living alone prefer to work out asimple code, like a flower pot in the window, ora shade that is lowered and raised according to a

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Bone health is important inseniors. Olderpeople on certainanti-epilepticmedicines are at agreater risk ofosteoporosis andfractures.


schedule, to reassure friends and neighbors thatall is well or to alert them if there are problems.

DRIVINGPeople who are having active seizures with lossof consciousness should not drive, no matterwhat their age.

However, seniors with epilepsy whose seizuresare fully controlled with medication (and whomeet other licensing requirements) can qualifyto drive in all parts of the United States.

In most states, they will have to show that theyhave met their state’s seizure-free requirements(usually between three months and one year,depending on the state). They will also have toprovide whatever statements from their doctorsthe Department of Motor Vehicles requires.

If driving is not an option, then using public trans-portation, signing up with local services for theelderly or disabled, or even moving to an apart-ment complex or community that has its owntransportation may be among the alternatives.

As society becomes moreunderstanding about epilepsy,seniors are finding that thecondition is no longer areason for shame or familyembarrassment.

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In about 50percent of casesof epilepsy inseniors the causeis not known.


Epilepsy TodayThere was a time when people with epilepsywere shunned by society. In contrast, epilepsyis now a well-understood neurological disorder, no more mysterious than other physical illnesses.

Today, we know that epilepsy is not contagious,not a mental illness, not a symptom of intellec-tual decline, and certainly not a reason forshame or family embarrassment.

Today, we know epilepsy can in many cases betreated successfully, enabling senior citizens tocontinue to live independently. Others mayprefer an assisted living or similar environmentwhere there are ready sources of help ifseizures occur.

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Sixty-year-oldMartha Laney grew to accept thefact that she hadepilepsy. She onlywished her chil-dren and grand-children were notso protective. Theydiscouraged herfrom leaving herhouse and foundexcuses to checkon her all thetime. She justwanted everyoneto take a deepbreath and relaxabout it.


451SLL

Rev. 3/09

800-332-1000

www.epilepsyfoundation.org

The H.O.P.E. Mentoring Program is supported

by an educational grant from


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