Epilepsy in the elderly: prognosis.

251 patients were admitted with seizures after the age of 60 years to the county hospital of Frederiksberg during the period 1979-1983, 163 had not received anti-epileptic treatment prior to admission, of these 151 had been admitted with their first seizure, 88 had established epilepsy at the time of admission. Of patients not previously treated and observed for at least 12 months, 62% remained seizure-free throughout the study, while 47% with established epilepsy were seizure-free. Of those not previously treated, 72% entered remission within the first year with a slight increase during the subsequent years. The first year was crucial in determining the long-term prognosis. Compared to previous studies on the prognosis of epilepsy it seems that prognosis in the elderly is as good or even better. Measurement of S-drug-levels at the time of seizure recurrence suggests that suboptimal treatment and poor compliance are important factors, thus indicating the need for regular control and monitoring of S-drug-levels. The presence of paroxysmal activity in the EEG was significantly correlated to seizure recurrence. Thirty-three patients entered nursing homes during the study period. Deterioration in residence status was correlated to degree of dementia and to the presence of focal neurological signs but not to age or to the severity of epilepsy.