hyponatraemia, hypokalaemia, hypocalcaemia) and hepatic impairment Endocrine/metabolic: renal failure, hypothyroidism, hypoglycaemia, hyperglycaemic non-ketotic states, electrolyte disturbances (e.g.Seizures resulting from anoxic brain injury may occur with respiratory as well as cardiac disease.Cardiovascular: vasovagal syncope, orthostatic hypotension, cardiac arrhythmias, structural heart disease, carotid sinus syndrome.Neurological: transient ischaemic attack, transient global amnesia, migraine, narcolepsy, restless legs syndrome.The differential diagnosis of seizures in the elderly includes :.Common problems that need to be considered include cardiac arrhythmias, hypoglycaemia, postural hypotension, carotid sinus sensitivity, adverse drug effects and vasovagal episodes.The majority of de-novo seizures in elderly people are partial in onset with or without secondary generalisation.confusion, headache, drowsiness, and Todd's paresis. There may be a witness report of pallor, cyanosis, abnormal movements, tongue biting, urinary incontinence, and impaired conscious level, or postictal features, e.g.There may be a history of trauma with evident bruises, cuts or burns.A reliable history and a witnessed event are generally of more value than investigations.Other possible underlying causes are hypertensive encephalopathy and cerebral vasculitis.Subdural haematoma is a potentially treatable cause of epilepsy in elderly people. Trauma is common in old age and older people are more likely to develop post-traumatic epilepsy.Seizures often have focal features but elderly patients do not always show neurological signs. The most common tumours found to produce seizures in later life are gliomas, meningiomas, and metastasis.Alzheimer's disease and epilepsy often coexist. Dementias of non-vascular origin give rise to seizures that are often easy to control. ![]()
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