Epilepsy in the elderly refers to epilepsy with onset after the age of 60, and its incidence is higher, and its etiology and clinical manifestations are specific and different from those of other age groups. The causes of epilepsy in the elderly are mostly secondary to cerebrovascular diseases, such as hypertensive atherosclerotic cerebral thrombosis, cerebral hemorrhage, subarachnoid space hemorrhage, cerebral embolism, etc., followed by brain tumors, brain atrophy, intracranial infections, traumatic brain injury, and metabolic diseases. Clinical manifestations of geriatric epilepsy Because of the memory and cognitive impairment and poor self-reporting ability of the elderly, the manifestations of geriatric epilepsy are mostly atypical. In particular, epilepsy in elderly people living alone in empty nests is often difficult to detect and delays diagnosis and treatment. The clinical type of seizures in the elderly varies, but some believe that partial epilepsy predominates in the elderly, especially complex partial epilepsy, which increases significantly with age. The EEG of seizures in the elderly mostly shows slow wave abnormalities, so the diagnosis of epilepsy in the elderly is based on clinical manifestations. In addition to the etiological treatment of epilepsy in the elderly, it is sometimes necessary to insist on long-term administration of antiepileptic drugs, and it is better to use them alone than in combination, and the dosage should be gradually increased. In the elderly, most of them have abnormal liver and kidney functions, so care needs to be taken when administering antiepileptic drugs to avoid applying drugs that may cause adverse effects on the organs.