Epilepsy treatment in the elderly.

The population is aging in all countries. The incidence of epilepsy increases with age, leading to an increase in the number of elderly epileptic patients. In addition to the diagnostic problems specific to this population, there are particular treatment difficulties for these age groups. Indeed, in addition to the physiological aging that modifies the metabolism of many drugs is added frequent comorbidities and consequently frequent co-medications. These comorbidities can be neurological, psychiatric, degenerative, but also cardiovascular, renal or hepatic... The availability of many new anti-epileptic drugs has not been very effective in comparison to the old ones. Studies show that new molecules are better tolerated and associated with a better compliance. They are also easier to use, some need just a single daily dose, systematic biological control is not necessary, and they have fewer interactions with co-medications than older anti-epileptic drugs. Thus, at present, these advances make the management of epilepsy more complex but also allow a better personalization of the treatment adapted to a particular patient in this fragile population.