Epilepsy in patients with Alzheimer's disease: A systematic review

Abstract

Alzheimer's disease (AD) and epilepsy are common disorders in the elderly. Evidence demonstrates that patients with AD have an increased risk of developing epilepsy and seizures.ObjectiveTo review epidemiological, clinical and treatment aspects of epilepsy and AD.MethodsWe reviewed databases (PubMED, LiLACS, Scielo) conducting a search for manuscripts using the terms Alzheimer's disease and epilepsy.ResultsManuscripts related to the areas of interest were reviewed. Studies revealed that epilepsy is more frequent among AD patients. The combined presence of the two disorders may be related to mechanisms of neuronal hyperexcitability as a consequence of amyloid-beta protein (Aβ) or phosphorylated tau accumulation, as well as to structural changes in cortical and hippocampal regions. Available data suggest that the new generation of antiepileptic drugs (AEDs) are better tolerated in the elderly population, and may also be the best option in patients with AD and epilepsy.ConclusionFurther prospective studies involving evaluation of concomitant dementia and epilepsy, neurophysiological findings and biomarkers need to be performed.

Neuronal Network Excitability in Alzheimer’s Disease: The Puzzle of Similar versus Divergent Roles of Amyloid β and Tau

“…Second, the extent and exact sites of tau phosphorylation may have to be taken into account to determine whether its overall effect opposes or contributes to the neuronal network hyperexcitability. A third important factor to consider when interpreting neuronal network hyperexcitability in AD studies is to take into account the role of other pathophysiological features of AD such as neuronal loss, gliosis, and E/I imbalance in enhancing hyperexcitability ( Miranda and Brucki, 2014 ; Busche and Konnerth, 2016 ; Zott et al, 2018 ; Vico Varela et al, 2019 ).…”

New Insights Into the Anticonvulsant Effects of Essential Oil From Melissa officinalis L. (Lemon Balm)

“…It has also been shown that epilepsy can result from infectious, metabolic, malformative, traumatic, tumoral or vascular conditions ( Engel, 2001 ). Diseases such as Alzheimer’s disease (AD), cerebral malaria (CM), bacterial meningitis, trauma and brain infections are common causes of epilepsy ( Murthy and Prabhakar, 2008 ; Ngoungou and Preux 2008 ; Miranda and Brucki, 2014 ). AD carries a significantly increased risk of developing epilepsy and seizures ( Miranda and Brucki, 2014 ), and it has been shown that people with hereditary/early-onset AD have developed unprovoked seizures at some point.…”

“…Diseases such as Alzheimer’s disease (AD), cerebral malaria (CM), bacterial meningitis, trauma and brain infections are common causes of epilepsy ( Murthy and Prabhakar, 2008 ; Ngoungou and Preux 2008 ; Miranda and Brucki, 2014 ). AD carries a significantly increased risk of developing epilepsy and seizures ( Miranda and Brucki, 2014 ), and it has been shown that people with hereditary/early-onset AD have developed unprovoked seizures at some point. Cerebral malaria is a potential cause of epilepsy in most of sub-Saharan Africa, which is considered an endemic area of the world ( Ngoungou and Preux, 2008 ; Dubé et al, 2009 ).…”

Mitochondria Re-set Epilepsy

“…TERI treatment was effective in a mouse model of Dravet syndrome, and it would be interesting to determine the effectiveness in other refractory epilepsy syndromes, like DOORS syndrome (Campeau et al, 2014). Interestingly, Alzheimer's (AD) and Parkinson's (PD) patients show a higher risk for seizures and epilepsy (Miranda and Brucki, 2014;Gruntz et al, 2018), but little is known about the underlying mechanisms or if this is also the result of altered set points. It would therefore be interesting to use the technology from Styr et al (2019) to lower hyperexcitability early in these diseases and test whether this slows disease progression.…”