目的了解老年人癫痫的患病状况、病因、治疗状况及死亡原因。方法对我院２３例老年癫痫患者进行了全面检查、抗癫痫药物监测及对部分患者测定血清白蛋白值。结果２３例癫痫患者占同期１２８１例老年患者的１．８％，该门诊平均年新发例病率为０．１６％；均为６０岁及以上始发的症状性癫痫，７０岁以上发病者占８２．６％，强直－阵挛型发作占６５．２％。单用苯妥英钠的１８例中，３３．３％的患者每日用２００～２５０ｍｇ，临床控制较好，维持苯妥英钠血药浓度于７．７～１６．２ｍｇ／Ｌ。癫痫发作病因确诊为脑血管病（未包括癫痫发作时无脑血管病症状的腔隙梗塞）９例，占３９．１％。死亡１６例，死因与肺部感染有关者１０例。结论脑血管病是老年人癫痫的主要原因；对单用苯妥英钠者首用剂量以２００ｍｇ／ｄ为佳；肺部感染是本组癫痫患者死亡的主要原因 Objective To understand the prevalence, etiology, treatment status and cause of death of epilepsy in the elderly. Methods A total of 23 cases of elderly patients with epilepsy in our hospital were examined, antiepileptic drugs monitoring and serum albumin values ​​for some patients. Results 23 cases of epilepsy patients accounted for 1.8% of the 1281 elderly patients in the same period, the average annual incidence of new cases of this clinic was 0.16%; all were 60 years of age and above the onset of symptomatic epilepsy, 70-year-old onset Accounting for 82.6%, 65.2% of tonic-clonic seizures. Phenytoin alone 18 cases, 33.3% of patients daily with 200 ~ 250mg, clinical control is better, to maintain the plasma sodium phenytoin concentration of 7.7 ~ 16.2mg / L. 9 patients (39.1%) were diagnosed as epileptic septicemia by cerebrovascular disease (not including lacunar infarction without symptoms of cerebrovascular disease during seizure). 16 cases died, the cause of death and pulmonary infection in 10 cases. Conclusions Cerebrovascular disease is the main cause of epilepsy in the elderly. The first dose of phenytoin alone is 200mg / d. Pulmonary infection is the main cause of death in patients with epilepsy