Abstract
Aim: To ascertain the current UK management processes for epilepsy in older patients. Method:A comparison of two general practice audits (first cycle) of people being treated for epilepsy aged 60 years and over in two geographical areas. Results:The cohort of 213 of patients came from 12 different practices. Seizure frequency in older people with epilepsy appears to be lower than that in younger patients; 80% are seizure-free. This compares with 40-60% of people in othergeneral practice note reviews and audits, where age is not a factor. Monotherapy rates are similar to the population in general. There is evidence of new antiepileptic drug use. Geriatricians receive virtually no referrals for the diagnosis of epilepsy. General physicians and neurologists receive the most. Geriatricians and general physicians very rarely provide follow-up; GPs complete most of this work, except where patients are still having seizures, and neurologists and specialist nurses then have a greater role to play. Having a dedicated local neurology departmentappears to increase initial referral rates to relevant specialist services and improve some outcome measures. Conclusions: Seizure frequency in older peoplewith epilepsy is low. Management and care for this patient group differs greatly from that provided for children and young adults.
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