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Seizures are sudden, uncontrolled electrical disturbances in the brain that can cause changes in behaviour, movements, feelings, and levels of consciousness. They are a symptom of underlying neurological conditions such as epilepsy but can also occur due to various other factors like head injuries, infections, or metabolic disorders. Seizures vary in intensity and duration, ranging from brief lapses in attention to severe convulsions.
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Statistics on seizures
Seizures affect millions of people worldwide, with epilepsy being one of the most common neurological disorders. According to the World Health Organization (WHO), around 50 million people globally have epilepsy.
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In Singapore, it is estimated that epilepsy affects approximately 0.6% of the population, translating to about 33,000 individuals. Among older adults, the incidence of seizures is notably higher, primarily due to age-related neurological changes and the prevalence of chronic conditions.
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Types of seizures
Seizures are broadly categorised into focal and generalised seizures:
Focal seizures: These begin in one specific area of the brain and may cause symptoms like unusual sensations, twitching, or confusion.
Generalised seizures: These involve the entire brain and include subtypes like tonic-clonic seizures (characterised by stiffening and jerking movements) and absence seizures (brief loss of awareness).
High-risk groups for seizures
Certain groups of elderly individuals are at a higher risk of experiencing seizures, for example:
Those with a history of stroke or traumatic brain injury.
Individuals with dementia, particularly Alzheimer’s disease.
Elderly patients with chronic conditions such as diabetes or hypertension.
Those taking medications that lower the seizure threshold, such as certain antidepressants or antipsychotics.
Risk factors and why seizures are dangerous for the elderly
Several factors increase the risk of seizures in older adults:
Neurological changes
Age-related decline in brain function and increased susceptibility to neurodegenerative diseases.Polypharmacy
The use of multiple medications can lead to drug interactions that trigger seizures.Metabolic imbalances
Conditions such as hypoglycemia, hyponatremia, or kidney failure.
Seizures pose significant dangers to elderly individuals due to their increased vulnerability and frailty. The sudden onset of a seizure can lead to falls, resulting in hip fractures, head injuries, and other complications, which are already major concerns in this age group.
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Furthermore, the postictal state (a period of confusion and weakness following a seizure) can further compromise their safety and independence. In severe cases, prolonged or recurring seizures, known as status epilepticus, can cause brain damage or even death if not promptly treated.
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Managing seizures in the elderly
Effective management of seizures in older adults involves a combination of medical treatment and environmental modifications:
Medical management
Anti-epileptic drugs (AEDs) are commonly prescribed but must be carefully selected and dosed to minimize side effects. Regular follow-ups and medication reviews are essential.Living environment design
Nursing homes and homes for elderly individuals should be designed to reduce fall risks. This includes:Installing grab bars and non-slip flooring.
Ensuring proper lighting to prevent tripping.
Removing sharp-edged furniture and other hazards.
Education and emergency preparedness
Staff in nursing homes should be trained to recognise and respond to seizures promptly. This includes knowing when to call for emergency medical assistance and providing basic first aid.
Conclusion
Seizures are a serious health concern for the elderly due to their potential to cause severe injuries, long-term complications, and even fatalities. Nursing home operators and caregivers must recognise the dangers associated with seizures and be prepared to manage such emergencies effectively. By implementing comprehensive care strategies and creating safe fall , we can mitigate the risks and improve the quality of life for elderly individuals facing this challenge.
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