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The clinical characteristics and prognosis of first ever seizures among the elderly (aged 65 years or more) were ascertained by following up a cohort of patients for 7 years. Twenty-three patients (mean age, 69.9 +/- 4.9 years) were registered in the Neurology Service between January 1988 and March 1989. Twelve patients had partial seizures with or without generalization. Three patients had status epilepticus, whereas ten had presented for single seizure. On presentation 61.9% patients had neurological deficits and 73.9% had one or more systemic disorder. Head computerized tomography scans were abnormal in 17 cases. Seizures were attributed to acute stroke (26.1%), trauma (8.7%), subdural haematoma, degenerative diseases of the brain, cerebral metastasis, or central nervous system infections. The cause was unknown in 43.5% cases. At the end of 7 years, follow-up was complete for 15 patients (65.2%). The mean duration of follow-up was 68.6 +/- 28.7 months. Eight (53.3%) patients had died. Nine patients (60%) had attained 2-year remission of which three remained seizure free throughout. Six of the seven living patients were continuing antiepileptic drugs treatment. Forty per cent of them were dependent on others for the activities of daily life.

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