Health

Aging Increases Seizure Risk — Know the Facts

You may think of a seizure as a rare health event affecting mainly children and younger adults with certain health conditions. But you may be surprised to learn that aging increases your risk of seizures after age 60. “About 20 years ago, researchers identified the fact that the risk of having a seizure increases with every 10 years after age 60,” explains UAB Professor of Occupational Therapy Laura Vogtle, Ph.D. “It’s important to know the conditions that are associated with seizures in older adults and how to protect your safety and well being if you — or someone close to you — experiences a seizure.”

Common Causes of Seizures in Older Adults

Several health conditions are associated with an increased risk of seizures in older adults, including:

• Strokes
• Brain tumors
• Head injuries
• Alzheimer’s disease

“While these conditions increase the risk of seizures in older adults, it’s important to understand that healthy older adults are also at increased risk,” observes Dr. Vogtle. “Some seizures in older adults are classified as cryptogenic, which means they have no known, identifiable cause.”

Types of Seizures and How to Stay Safe

The most common type of seizure is the partial (simple or complex) seizure, which was once commonly known as petit mal. “These are very brief, and the individual may experience few — if any — physical symptoms,” says Dr. Vogtle. “In fact, many people who have these types of seizures seem to ‘blank out’ for a brief time, and then return to their usual self.” More significant and potentially serious seizures are known as generalized seizures. “Loss of consciousness occurs with these types of seizures, which makes them potentially more dangerous.”

Dr. Vogtle stresses that any seizure is frightening and poses very real safety risks. “Burns are associated with seizures, often occurring from people falling into a stove during the seizure event,” she explains. “Also, fractures can often occur from falls that people sustain during a seizure.” While any seizure is potentially dangerous, there are a few simple and important steps you can take to protect the safety of a friend or loved one during a seizure event.

• Turn the individual on his or her side.
• Move all hard and sharp objects away.
• Loosen any ties, scarves, or tight clothing at the neck.
• Place a folded jacket or blanket under the head if possible.
• Observe the individual closely and time the seizure.
• Do not try to restrain the individual.
• If the seizure has not stopped after 15 — 20 minutes, call 9-1-1 for help.

Dr. Vogtle says that while some people come out of seizures quickly, others remain in a ‘twilight’ state for a period of time. “Sometimes, people can’t communicate during this stage, so it’s important to continue observing them closely,” she adds.

Dr. Vogtle emphasizes that seizures can be particularly difficult for older adults due to public embarrassment that can lead to social isolation. “Older adults also have a real concern about losing their autonomy because of seizures, which can lead to further social isolation and depression.” She says that adults who have experienced a seizure typically wait three to six months before driving again, depending on a particular state’s requirements and cause and type of seizure. “Many older adults won’t tell their physician about a seizure event because of the risk of losing driving privileges and the accompanying loss of autonomy,” she explains. “However, if you don’t talk about your seizures, you can’t get treatment.” Dr. Vogtle emphasizes that older adults should become familiar with alternative transportation in the event that driving privileges are suspended because of a seizure. “Para-transit services will provide transportation to adults with a history of seizures, though a physician note may be required,” she says. “Also, senior centers and churches or synagogues are possible resources for alternative transportation for older adults.”

Treatments for Seizures

If you or a loved one has suffered from seizures, the good news is that effective treatments are available. While treatments for seizures vary depending on the type and cause of the seizure, the most common effective treatments include:

• Medications. “Dilantin and Phenobarbital used to be the most common, though many newer medications are now available that may be more effective to treat seizures,” says Dr. Vogtle. “Seizure control with medication isn’t permanent,” she explains. “While a medication may work initially, it may stop working after a time. That’s why it’s important to work closely with your doctor in finding the medication that has the fewest side effects and works best for your seizure control.”
• Vagal nerve stimulation. “This is a procedure that sends electrical impulses to the brain that can stop a seizure from occurring,” explains Dr. Vogtle. A device called a pulse generator is surgically implanted in the chest, and a wire is threaded under the skin that connects the pulse generator to the left vagus nerve in the neck. The pulse generator then sends out electrical signals along the vagus nerve to the brain. “Patients can press a button that sends impulses through the vagus nerve to the brain when they’re feeling close to having a seizure.”
• Temporal lobectomy. “This procedure involves destroying some of the brain tissue in one part of the brain responsible for causing seizures, and it can be very effective for patients who are eligible and haven’t achieved success with other treatments,” Dr. Vogtle observes.

“It’s critically important for older adults to share all information about seizures with their physician,” Dr. Vogtle says. “Then, you can work together to find the most effective treatment to control your seizures and maintain an active, independent lifestyle.”