The elderly with epilepsy, treatment needs to be based on the patient’s seizure type, onset history and treatment history of various diseases, the elderly due to a variety of cerebrovascular diseases, in the choice of treatment should pay more attention to the symptoms of the elderly with seizures? 1, the patient suddenly stops moving, calling out, eyes dazed, accompanied by chewing, swallowing, smacking and other movements, or with a slight shaking of the face and both upper limbs, we should pay attention to record the exact duration of the seizure, ask the patient after the seizure what discomfort before and after the seizure, whether they know there is a seizure. 2. Whether the patient has a broken tongue (spitting blood from the mouth), any bruises, bruises on the body during convulsions, and incontinence of stool and urine (especially urine) during seizures in the elderly, these conditions can help determine whether the patient has indeed lost consciousness. 3, the time and place of the patient’s seizure is day or night, night seizures are seizures during sleep, or not asleep seizures, seizures in the presence of people, or no one present seizures, these are helpful to identify whether it is epilepsy in the elderly or hysterical seizures. 4. For elderly patients with grand mal seizures, attention should be paid to observe the presence of aura symptoms, such as the presence of hallucinations or delusions before the patient starts to convulse, and the presence of emotional reactions. 5, grand mal seizures in the elderly when the convulsions start bilaterally at the same time or from one side, which side or which limb convulsions are heavier and last longer, whether the head and eyes are crooked to one side during the seizure, whether the corners of the mouth are crooked to one side, these may suggest the starting site of epileptic discharge in the elderly, which is the site of the lesion. 6. In patients who suddenly fall, lose consciousness and do not have convulsions, attention should be paid to observe and ask whether there is panic, chest tightness, cold sweat before the seizure, whether the pulse is too fast or too slow, how regular and strong it is, how high or low the blood pressure is, whether the onset is after meal or starvation state, whether the whole body is stiff or soft, these are helpful to identify whether it is syncope or epilepsy in the elderly. The treatment of elderly patients with epilepsy is generally controlled by medication and surgical radical treatment. Surgery requires strict evaluation and preoperative MRI, EEG testing and pet-ct.