He had a history of hypertension for more than 10 years and had seizures secondary to cerebral hemorrhage. He was given carbamazepine orally at 300mg in the morning and 300mg in the evening. He was transferred to our hospital and his antiepileptic drugs were adjusted to lamotrigine 50mg bid, and he has not had any seizures, his hyponatremia has disappeared, his blood pressure has returned to normal, and his antihypertensive drugs have been reduced to one. The incidence of epilepsy in the elderly is high, mostly symptomatic, and the cause is commonly due to stroke, brain tumor, traumatic brain injury, and metabolic diseases. However, the elderly have their own special physiological structure and often combine with a variety of underlying diseases. The choice of antiepileptic drugs for elderly patients with epilepsy requires attention to the following points: 1. Prone to adverse reactions. The incidence of adverse reactions in elderly patients with epilepsy taking antiepileptic drugs is two to three times that of young people, especially carbamazepine is more prone to hyponatremia, hypertension, ataxia, phenytoin sodium causing osteoporosis, etc. A new generation of antiepileptic drugs such as lamotrigine and levetiracetam can be chosen. 2, the dose of antiepileptic drugs should be reduced appropriately. The elderly, as they age, their body water content decreases, their weight decreases, their plasma albumin decreases, their liver and kidney metabolism decreases, their drug clearance decreases, and the dose of anti-epileptic drugs does not need to be sufficient to achieve effective treatment and to avoid adverse drug reactions. The actual fact is that you can be able to get a good deal on your own. The elderly are often combined with other diseases such as hypertension, diabetes, cerebral infarction, etc., also need to take long-term medication, while taking a variety of drugs to pay attention to drug interactions. For example, aspirin can increase the blood concentration of sodium valproate, and when these two drugs are taken together, the dose of sodium valproate should be reduced appropriately. The rational application of antiepileptic drugs needs to be individualized and comprehensive, to actively control epilepsy and improve the quality of life of elderly patients.