Among 50 geriatric inpatients (average age 79) with late-onset epilepsy (average duration two years), 28 had grand mal attacks, 12 had focal attacks, seven had both. None had petit mal, confirming its rarity in the elderly. The epilepsy followed cerebrovascular disease (usually with hemiplegia) in 21 patients (8 per cent of all our patients with hemiplegia in the two-year study period developed epilepsy). Associated conditions included dementia in seven; and cerebral tumours (usually metastases) in five. This latter group survived less than two months on average from the onset of their attacks. The majority of patients (42 out of 50) were unfit for full neurological investigation; and the dangers of some procedures in the elderly are stressed.