New Onset (Incidence) of Epilepsy and Seizures in Nursing Home Residents.

Epilepsy or seizure diagnosis was based on nursing home assessment records and ICD-9 codes, not clinical adjudication, so coding may have varied between homes. Convulsions may not have been witnessed or recorded, so some new seizures were likely missed. Residents dropped out of the analysis each year because they developed a diagnosis, died, were discharged, or lacked complete records, which may have undercounted incidence. Some residents may have had unrecognized seizures before admission, which could have inflated the first-year incidence. The study did not measure later seizures, antiseizure medication use, medication side effects, or economic impact. Because it was a cohort of survivors, the authors say it likely underrepresents the actual incidence.

The work was supported in part by NIH/NIA and ASPH/CDC. Dr. Leppik received honoraria for consulting from Sunovion and for speaking from Eisai.

Do not read these incidence rates as a reason to start antiseizure medication after one seizure. The study did not track later seizures, medication use, or outcomes, and it says the risk and benefit balance of treating all seizures is unknown.