Special features of EEGs in old age

Background Special features and importance of EEG in the diagnostics of epilepsy in old age. Objective Use of routine EEG and video EEG monitoring in the diagnostics of late onset epilepsy. Material and methods Selected literature review. Results Epileptiform discharges (EDs) on routine EEG in late onset epilepsy occur in 16.6-82.6% of patients with a weighted average of 38.6%. Diagnostic yield of EEG with respect to EDs can be significantly increased by a short time interval between the last seizure and the EEG examination as well as by sleep recordings. The EDs are focal in the vast majority of cases with a clear temporal preponderance. The EDs occur more frequently in patients with lesions (especially tumors) on MRI. Video EEG monitoring represents a valuable tool for the correct differential diagnosis of seizures in the aged, which is often further complicated by a large number of comorbidities. Video EEG monitoring usually facilitates a correct diagnosis after short recording times and therefore should be used more readily in this patient group. Conclusion Routine EEG and video EEG monitoring represent valuable and essential tools in the diagnosis of epilepsy in old age.