The goal of our study is to identify the differences in epilepsy in the elderly group compared to the younger age group.

Epilepsy is the third most common neurological disorder in the elderly, however, the distinguishing features of epilepsy in this age group have not been as extensively studied.

As part of development of an epilepsy database we retrospectively reviewed the medical records of patients with a diagnosis of epilepsy. Elderly patients were defined as > 60 years of age and those younger patients with epilepsy served as controls. ILAE classification for seizures (2017) was utilized and p-value <0.05 was considered as statistically significant.

Our study group includes 418(25.10%) elderly patients and 1247(74.89%) control patients. 75.8%of the elderly group had focal epilepsy as compared to 59.5% of the control group (p <0.05) whereas generalized epilepsy was diagnosed in 5%of the elderly patients as compared to 12.1%of the controls (p< 0.05). Aura was less frequently reported in the elderly (19.2%) as compared to controls (26.5%, p,0.05). No differences in the semiology were noted in both groups. Main etiology in the elderly vs controls, respectively, were cerebrovascular disease (31.3% vs 8.7%), brain trauma (13.9% vs 13.6%) and brain tumor (6.0% vs 5.1%). No cause was identified in 48.1%of the elderly vs 58.1% of controls (p<0.05). Elderly were less likely to have generalized epileptiform discharges as compared to controls (5% vs 12.1%,). Elderly patients were more likely to be seizure free (23.7% vs 19.8%- NS)

Older patients are more likely to have focal seizures and aura are less frequently reported. They are more likely to have known etiology with cerebrovascular disease as the most common cause. Seizures are more likely to be well controlled in the elderly compared to the younger cohort.