Epileptischer Anfall bei älteren Patienten

ZUSAMMENFASSUNG

Die Inzidenz vorübergehender Bewusstseinsverluste steigt mit zunehmendem Alter an, dies gilt jedoch sowohl für Anfälle epileptischer Genese als auch für Bewusstseinsverluste nicht epileptischer Natur, insbesondere aus kardialer oder zerebrovaskulärer Ursache. Zur sicheren Differenzierung ist daher primär eine umfassende Anamnese sowohl der Semiologie des Ereignisses als auch möglicher Auslösefaktoren zu erheben und, je nach Ergebnis, eine gezielte apparative Diagnostik durchzuführen. Bei Diagnose einer Epilepsie muss im Rahmen der Therapie beachtet werden, dass im Alter aufgrund einer veränderten Pharmakodynamik und vielfacher Wechselwirkungen, eine medikamentöse Therapie oftmals durch nicht akzeptable unerwünschte Arzneimittelwirkungen erschwert wird. Weitere Therapiemöglichkeiten sind auch im höheren Lebensalter zu erwägen, wie die verschiedenen Möglichkeiten der Epilepsiechirurgie.

ABSTRACT

The incidence of transient losses of consciousness increases with age, on the one hand due to epileptic seizures, on the other hand because of diseases of non-epileptic nature, especially cardiac or cerebrovascular causes. For reliable differentiation, a comprehensive anamnesis of both the semiology of the event and possible triggering factors is necessary and, depending on the result, must be succeeded by targeted diagnostic investigations. When diagnosing epilepsy and therefore evaluating an antiseizure medication, it is important to consider that in older ages, due to changed pharmacodynamics and multiple drug interactions, this drug therapy is often difficult by unacceptable adverse drug effects. Also, in older ages other therapy strategies should be evaluated such as epilepsy surgery.

Schlüsselwörter

Elektroenzephalografie - Medikamenteneffekte - Epilepsie - Altersmedizin

Key words

Electroencephalography - drug effects - epilepsy - geriatric medicine

Publication History

Article published online:
28 July 2022

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