When seizures are complicated by coma.

Convulsions in elderly patients result from systemic biochemical or focal structural processes. These patients require a thorough evaluation, because idiopathic seizures are virtually unknown in this age group. Marginal circulatory and pulmonary function compromises central nervous system function, which can result in prolonged postictal coma. Furthermore, the patient's fragility can coma. Furthermore, the patient's fragility can complicate anticonvulsant therapy. The physician must be prepared to support the patient in prolonged postictal coma, since many patients can recover the preictal level of function.