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However, it's important to note that diagnosed epileptic seniors are not at higher risk for other neurological disorders such as Parkinson's disease, multiple sclerosis or dementia. WARNING SIGNS MAY BE SUBTLE Seizure symptoms in older adults are essentially the same as other age groups. But when seniors blank out for a few minutes and can't recall what just happened, they may just brush it off as a "sign of old age." As a result, this important seizure warning sign can go unnoticed in older adults. A complex partial seizure often presents with less dramatic physical signs in comparison to a grand mal seizure, in which the patient exhibits a loss of consciousness and violent muscle contractions. The event can be as brief as 60 seconds in duration. Most common in seniors, a partial seizure begins with an electrical discharge in one specific area of the brain—that does not result in the loss of consciousness—but may present with some brief involuntary jerking. Additionally, the patient may experience symptoms such as temporary emotional instability; changes in the way things look, smell, feel, taste or sound; or feel tingling or dizziness. THE CHALLENGE OF AN ACCURATE DIAGNOSIS A key obstacle to confirming epilepsy in older adults is the failure to recognize symptoms that can often overlap with other neurological conditions. Diagnosis is generally determined by the use of these five tools: • A detailed patient history • Clinical examination (detailing a moment-by-moment seizure history) • EEG (electroencephalography) to measure brain waves and exclude subtle seizures • Cardiovascular evaluation • Lab testing, including EKG, MRI and blood work-up Once a neurologist or epileptologist has diagnosed the disease, medication therapy usually begins immediately. However, this process is not a "one size fits all" blanket prescription, due to the fact that many seniors are already taking medications to regulate other medical conditions. Doctors need to carefully weigh the risks of certain drug interactions and other potential side effects when anti-seizure medication is combined with other prescribed drugs. Around 60–70 percent of seniors will achieve seizure control with medication, and up to 80 percent who respond to the medication will remain seizure-free. Even faced with these obstacles, many older patients with epilepsy are able to function normally and independently. As with all serious medical conditions, the severity of any condition dictates the level of independence the patient can safely sustain. Seniors, in partnership with spouses, family members and their medical care teams, should work closely together to establish a safe environment for the affected person that will offer the safest and highest quality of life possible. MICHAEL'S SEIZURE STORY Michael Luszik never experienced any warning signs of epilepsy. The 75-year-old Jackson resident experienced his first seizure early in the morning last March, but since he was still asleep, he was unaware it happened. But his wife, Patricia, was awake, and saw Michael's body stiffen and back arch while making gurgling noises—indications that he was having a tonic-clonic seizure. Patricia called 911, and Michael was transported to CentraState Emergency Department. "By that time I was awake and confused about what had happened," Michael says. If Patricia had not been present when Michael experienced his seizures, he would have likely had no idea they had occurred. "After advanced testing was done using video EEG recording [a brain recording device that helps in confirming or excluding seizures] Michael's epileptic episode was confirmed," says Dr. Zaatreh, who then came to see Michael to discuss his epilepsy treatment. "In addition to his 'big seizure,' his recording showed that he was having frequent brief seizures in his brain lasting 10–15 seconds, and this would put him at high risk of having more severe generalized seizures," Dr. Zaatreh explains. "My family and I cannot say enough good things about Dr. Zaatreh," Michael says. "From the beginning, he explained everything, which was a big comfort. I feel very confident in his care and blessed to have him as my doctor. His approach to care is very intelligent, caring and complete." Michael now manages his seizures with medication and is able to continue enjoying "golfing and life in general," he says. For more information about The Comprehensive Epilepsy Center at CentraState, call 866-CENTRA7 (866-236-8727) or visit CentraState.com/Epilepsy. This article is a portion of a piece that was published on LiveScience.com. Megdad Zaatreh, MD board-certified neurologist 13 www.centrastate.com Summer 2015

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