1. A 65 years old man is brought to the emergency room with history of seizures involving all 4 limbs and the whole body. The description fits a generalized tonic clonic seizure. This is the first time he has developed a seizure. Which of the following statements is true about this man?
1. This man has a genetically mediated epileptic disease.
2. This man most probably has an inborn error of metabolism
3. This man has a high risk of brain tumors
4. This man has a high risk of stroke

Answer: The correct answer is (d). Onset of seizures in late life may be a risk factor for stroke, possibly because covert cerebrovascular disease can often be the mechanism of new onset epilepsy in older patients. New onset of seizures in older patients should prompt evaluation and treatment for stroke risk factors.