Long-term EEG monitoring in the elderly experiencing sudden cognitive changes

When an elderly person begins to experience cognitive changes, people often ignore the symptoms. We are used to expecting cognitive decline as part of the aging process. However, there is a big difference between the gradual cognitive decline associated with normal aging or even debilitating conditions like dementia and sudden cognitive changes that can signal an abrupt problem. In fact, many people are surprised to learn that recent epileptic seizures can occur even in older people. The elderly account for somewhere between 1/4th and ½ of all new onset epilepsy patients and long-term EEG monitoring can help make a diagnosis much more quickly.

How do you know what causes cognitive changes in an elderly person?

We have several tools available to help us determine what causes cognitive changes. If the changes are abrupt, the first consideration is normally a stroke. We use brain imaging, blood pressure tests, pulse and blood tests to determine if a person is having a stroke.
However, if we’re not dealing with the immediate period surrounding the sudden cognitive change, those tools aren’t as helpful. Long-term EEG monitoring in the elderly who experience sudden changes in their cognition will often result in an epileptic diagnosis that, when treated, can improve cognitive function and halt further cognitive decline.

Why do the elderly get epilepsy?

There are many reasons why the elderly can develop epilepsy. In general, there are three categories of epilepsy: genetic, structural/metabolic, and unknown cause. These categories also apply to the elderly. While young people with epilepsy often have a genetic cause, epilepsy in the elderly is more likely to be associated with accumulated injuries to the brain, including strokes, degenerative conditions, tumors, and traumatic brain injury. Stroke is a major risk factor for epilepsy in the elderly, increasing the risk of epilepsy in the year after stroke by 20-fold.

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