Seizures in Alzheimer's disease: a retrospective study of a cohort of outpatients

Abstract

The aim of our study was to define the frequency of seizures in a population of outpatients attending a cognitive function clinic in Italy and to identify risk factors for seizures in patients with Alzheimer's disease. Methods. In this retrospective study, we analyzed our clinical records to gather information on patients' demographic, metabolic, cardiovascular and cognitive features. We sought to determine the significance of abnormal neuroimaging findings and the use of potentially epileptogenic drugs on the onset of seizures. From the records of 583 patients referred to the clinic for cognitive disturbances, we identified 145 patients with Alzheimer's disease. Results. Of these 145 patients, 14 (9.7%) had a history of complex partial or generalised seizures, or both. Of the risk factors identified, onset of seizures was associated with male gender and none of the patients with seizures had diabetes. The risk of seizure onset was higher in Alzheimer's disease patients with hyperlipaemia and severe dementia. No other risk factors were identified, although hypertensive patients seemed to be protected. Conclusions. Seizures in Alzheimer's disease are frequent and often under-recognized. In elderly patients, especially those with Alzheimer's disease, correct diagnosis and treatment are important to prevent disease from worsening and disability from increasing. Patients with dementia should routinely undergo history-taking designed to elicit a history of seizures and define patients at high risk.

Alterations of Coherent Theta and Gamma Network Oscillations as an Early Biomarker of Temporal Lobe Epilepsy and Alzheimer’s Disease

“…Thus, aging is a common and well-established risk factor for epilepsy and AD (Armon et al, 2000; Maguire and Frith, 2003; Amatniek et al, 2006; Bernardi et al, 2010; Born et al, 2014; Chan et al, 2015). Besides, AD may be an important cause of epileptic disorders, as shown in elderly humans (Armon et al, 2000; Bird et al, 2005; Bernardi et al, 2010; Palop and Mucke, 2016) and in animals with AD models (Bezzina et al, 2015; Chan et al, 2015). Patients with AD have a 5- to 10-fold increased risk of the development of seizures or other forms of epileptiform activity (Amatniek et al, 2006).…”

Reduction of epileptiform activity by valproic acid in a mouse model of Alzheimer's disease is not long-lasting after treatment discontinuation

“…Patients with Alzheimer's disease (AD) are at increased risk for unprovoked seizures and epilepsy as compared with agematched controls (Amatniek et al, 2006;Bernardi et al, 2010;Friedman et al, 2012;Hauser et al, 1986;Pandis and Scarmeas, 2012). Seizures can occur at an early stage in both familial and sporadic AD (Vossel et al, 2013), as well as in advanced AD (Mendez et al, 1994;Romanelli et al, 1990).…”

Seizures in Setting of Dementia

“…These potentially could have been complex partial seizures (CPS) [22]. The study by Bernardi et al also showed that CPS with secondary generalization was the most common seizure type [26]. CPS in these patients most commonly manifest as confusion spells (dyscognitive) with minimal motor manifestations and hence can be difficult to distinguish from behavioral changes and are highly likely to go unrecognized [8].…”