Sirven JI: Acute and chronic seizures in patients older than 60 years. May Clin Proc 2001;76(2):175-83.

Browne TR, Holmes GL: Epilepsy. N Engl J Med 2001;344(15):1145-51.

The prevalence and incidence of epilepsy rise with age. Among persons ages 60 and older, the incidence of epilepsy is higher than the incidence of Alzheimer-type dementia. These articles provide discussions of epilepsy diagnosis and treatment. Sirven emphasizes new medical and surgical therapies, and Browne and Holmes discuss issues such as drug toxicity, inadequate seizure control, discontinuing therapy, and neurologic consultation. Both articles discuss diagnostic tests used to identify the underlying disorder. Experts prefer magnetic resonance imaging to computed tomography because it is more likely to reveal small lesions such as tumors or mesial temporal sclerosis. Tables present drug choices related to seizure type, dosages, adverse effects, and advantages and disadvantages. Primary care providers will probably care for many patients with epilepsy and need to remain current about new developments.