Differential diagnosis of epileptic fits in the elderly Volume 21, issue 3, juillet-août-septembre 2009

Service de médecine interne et de gérontologie clinique, CHU de Reims, hôpital Maison-Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France, Faculté de médecine, EA 3797, université de Reims Champagne-Ardenne, 51092 Reims, France

Difficulties of differential diagnosis of epileptic fits in elderly subjects result at once from difficulties related to positive diagnosis of the fits and to the specificities of the geriatric care. For elderly patients with polypathology and polypharmacy differential diagnoses are numerous because of anamnesis collection often difficult and atypical semiology. Faintness, brief loss of consciousness, falls and delirium can have multiple aetiologies sometimes overlapped, giving specificity to the geriatric approach. Whatever is the quality of this approach to explore differential diagnoses, it will persist situations where the question of epileptic fits will remain. Collaboration between geriatricians and neurologists takes here all it sense.