Clinics in geriatric medicine
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Strokes are the most common cause of epilepsy in the elderly. Seizures after an acute stroke have been estimated to occur in 5% to 10% of cases. A distinction between early and late seizures should be made. ⋯ Prophylactic treatment with antiepileptic drugs is probably not indicated in most types of strokes, except for subarachnoid hemorrhage after a ruptured intracranial aneurysm. When early seizures develop, treatment is indicated but may not be necessary for a prolonged period of time. If late seizures develop, chronic anticonvulsant therapy is recommended.
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The significance, management and prognosis of several disorders affecting either vision or ocular motility are discussed. Transient and persistent visual loss are common problems in the elderly. ⋯ The various pathologic conditions that can affect the ocular motor nerves in the cavernous sinus are mentioned. The problem of differentiating benign ischemic lesions causing a third nerve palsy from ominous compressive palsies due to aneurysms is addressed, with emphasis on the clues provided by the pupil.