Neurol. praxi. 2020;21(6):454-459 | DOI: 10.36290/neu.2020.038

Epilepsy in patients with dementia

MUDr. Eva Pešlová, prof. MUDr. Milan Brázdil, Ph.D.
I. neurologická klinika Fakultní nemocnice u sv. Anny a LF MU, Brno

Epileptic seizures are more prevalent in patients with dementia in comparison to normal aging population. Incidence of seizures depends on the aetiology and level of progression. Studies on the patients with Alzheimer´s dementia show wide range of epilepsy prevalence between 4 and 47 % depending on the patient group and the study design with the highest prevalence in the early onset autosomal dominant Alzheimer dementia. Both the diagnostics and treatment of epilepsy in dementia are quite specific. Diagnostics require cooperation with the caregivers and repeated EEG examination ideally with preceding sleep deprivation. The most important recommendations are exclusion of acute symptomatic seizures, choosing the antiepileptic medication with least harmful effects on cognition in the lowest effective doses with the drug level monitoration.

Keywords: dementia, epilepsy, Alzheimer dementia, antiepileptic medication.

Received: March 27, 2020; Revised: April 6, 2020; Accepted: April 6, 2020; Prepublished online: April 6, 2020; Published: January 6, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Pešlová E, Brázdil M. Epilepsy in patients with dementia. Neurol. praxi. 2020;21(6):454-459. doi: 10.36290/neu.2020.038.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Bakker A, Krauss GL, Albert MS, Speck CL, Jones LR, Stark CE, Yassa MA, Bassett SS, Shelton AL, Gallagher M. Reduction of Hippocampal Hyperactivity Improves Cognition in Amnestic Mild Cognitive Impairment. Neuron 2012; 74(3): 467-74. PubMed, doi: 10.1016/j.neuron.2012.03.023. Go to original source... Go to PubMed...
    2. Beghi E, Caprio A, Forsgren L, Hesdorffer DC, Malmgresn K, Sandet JW, Tomson T, Hause WA. Recommendation for a Definition of Acute Symptomatic Seizure. Epilepsia 2010; 51(4): 671-75. PubMed, doi: 10.1111/j.1528-1167.2009.02285.x. Go to original source... Go to PubMed...
    3. Belcastro V, Casto C, Galletti F, Pisani F, Calabresi P, Parnetti L. Levetiracetam Monotherapy in Alzheimer Patients with Late-Onset Seizures: A Prospective Observational Study. European Journal of Neurology 2007; 14(10): 1176-78. PubMed, doi: 10.1111/j.1468-1331.2007.01907.x. Go to original source... Go to PubMed...
    4. Costa C, Romoli M, Liguori C, Farotti L, Eusebi P, Bedetti C, Siliquii S, Cesarini EN, Romigi A, Mercuri NB, Parnetti L, Calabresi P. Alzheimer's Disease and Late-Onset Epilepsy of Unknown Origin: Two Faces of Beta Amyloid Pathology. Neurobiology of Aging 2019: 61-67. PubMed, doi: 10.1016/j.neurobiolaging.2018.09.006. Go to original source... Go to PubMed...
    5. Cretin B. Pharmacotherapeutic strategies for treating epilepsy in patients with Alzheimer's disease. Expert Opinion on Pharmacotherapy 2018; 19(11): 1201-09. Taylor and Francis+NEJM, doi: 10.1080/14656566.2018.1496237. Go to original source... Go to PubMed...
    6. Cumbo E, Ligori LD. Levetiracetam, Lamotrigine, and Phenobarbital in Patients with Epileptic Seizures and Alzheimer's Disease. Epilepsy & Behavior: E&B 2010; 17(4): 461-466. PubMed, doi: 10.1016/j.yebeh.2010.01.015. Go to original source... Go to PubMed...
    7. Dementia. https://www.who.int/news-room/fact-sheets/detail/dementia. Viděno 30. leden 2020.
    8. Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S. ILAE Official Report: A Practical Clinical Definition of Epilepsy. Epilepsia 2014; 55(4): 475-82. PubMed, doi: 10.1111/epi.12550. Go to original source... Go to PubMed...
    9. Fleisher AS, Truran D, Mai JT, Langbaum JBS, Aisen ps, CUmmings JL, Jack CR, Weiner MW, Thomas RS, Schneider LS, Tariot PN, Alzheimer´s Disease Cooperative Study. Chronic Divalproex Sodium Use and Brain Atrophy in Alzheimer Disease. Neurology 2011; 77(13): 1263-71. PubMed, doi: 10.1212/WNL.0b013e318230a16c. Go to original source... Go to PubMed...
    10. Friedman D, Honig LS, Scarmeas N. Seizures and Epilepsy in Alzheimer's Disease. CNS Neuroscience & Therapeutics 2012; 18(4): 285-94. PubMed, doi: 10.1111/j.1755-5949.2011.00251.x. Go to original source... Go to PubMed...
    11. Hauser WA, Annergers JF, Kurland LT. Incidence of Epilepsy and Unprovoked Seizures in Rochester, Minnesota: 1935-1984. Epilepsia, 1993; 34(3): 453-68. PubMed, doi:10.1111/j.1528-1157.1993.tb02586.x. Go to original source... Go to PubMed...
    12. Hitchings AW. Drugs That Lower the Seizure Threshold. Adverse Drug Reaction Bulletin 2016; 298(1): 1151. journals.lww.com, doi: 10.1097/FAD.0000000000000016. Go to original source...
    13. Holth JK, Bomben VC, Reed JG, Inoue T, Younkin L, Pautler RG, Botas J, Noebels JL. Tau Loss Attenuates Neuronal Network Hyperexcitability in Mouse and Drosophila Genetic Models of Epilepsy. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience 2013; 33(4): 1651-59. PubMed, doi: 10.1523/JNEUROSCI.3191-12.2013. Go to original source... Go to PubMed...
    14. Horváth A, Szücs A, Hidasi Z, Csukly G, Barcs G, Kamondi A. Prevalence, Semiology, and Risk Factors of Epilepsy in Alzheimer's Disease: An Ambulatory EEG Study. Journal of Alzheimer's Disease: JAD 2018; 63(3): 1045-54. PubMed, doi: 10.3233/JAD-170925. Go to original source... Go to PubMed...
    15. Lam AD, Deck G, Goldman A, Eskandar EN, Noebels J, Cole AJ. Silent Hippocampal Seizures and Spikes Identified by Foramen Ovale Electrodes in Alzheimer's Disease. Nature Medicine 2017; 23(6): 678-80. PubMed, doi: 10.1038/nm.4330. Go to original source... Go to PubMed...
    16. Landi S, Petrucco L, Sicca F, Ratto GM. Transient Cognitive Impairment in Epilepsy. Frontiers in Molecular Neuroscience 2019; 11. PubMed Central, doi: 10.3389/fnmol.2018.00458. Go to original source... Go to PubMed...
    17. Leth-Møller KB, Hansen AH, Torstensson M, Andersen SE, Odum L, Gislasson G, Torp-Pedersen C, Holm EA. Antidepressants and the Risk of Hyponatremia: A Danish Register-Based Population Study. BMJ Open 2016; 6(5): e011200. bmjopen.bmj.com, doi: 10.1136/bmjopen-2016-011200. Go to original source... Go to PubMed...
    18. Li Y, Sun H, Chen Z, Xu H, Bu G, Zheng H. Implications of GABAergic Neurotransmission in Alzheimer's Disease. Frontiers in Aging Neuroscience 2016; 8. PubMed Central, doi: 10.3389/fnagi.2016.00031. Go to original source... Go to PubMed...
    19. Lippa CF, Rosso A, Hepler M, Jenssen S, Pillai J, Irwin D. Levetiracetam: A Practical Option for Seizure Management in Elderly Patients with Cognitive Impairment. American Journal of Alzheimer's Disease and Other Dementias 2010; 25(2): 149-54. PubMed, doi: 10.1177/1533317508325095. Go to original source... Go to PubMed...
    20. McAreavey MJ,Ballinger BR, Fenton GW. Epileptic Seizures in Elderly Patients with Dementia. Epilepsia 1992; 33(4): 657-60. Wiley Online Library, doi: 10.1111/j.1528-1157.1992.tb02343.x. Go to original source... Go to PubMed...
    21. Mendez MF, Catanzaro P, Doss RC, Arguello R, Frey WH. Seizures in Alzheimer's Disease: Clinicopathologic Study. Journal of Geriatric Psychiatry and Neurology 1994; 7(4): 230-233. PubMed, doi: 10.1177/089198879400700407. Go to original source... Go to PubMed...
    22. Mendez MF, Cummings JL. Dementia : A Clinical Approach. 3rd ed, Philadelphia, PA: Butterworth-Heinemann 2003. Trove, https://trove.nla.gov.au/version/45744865.
    23. Mendez M, Lim G. Seizures in Elderly Patients with Dementia: Epidemiology and Management. Drugs & Aging 2003; 20(11): 791-803. PubMed, doi: 10.2165/00002512-200320110-00001. Go to original source... Go to PubMed...
    24. Möller HJ, Graeber MB. The Case Described by Alois Alzheimer in 1911. Historical and Conceptual Perspectives Based on the Clinical Record and Neurohistological Sections. European Archives of Psychiatry and Clinical Neuroscience 1998; 248(3): 111-22. PubMed, doi: 10.1007/s004060050027. Go to original source... Go to PubMed...
    25. Qing H, He G, Ly PTT, Fox CJ, Staufenbiel M, Cai F, Zhang Z, Wei S, Sun X, Chen CH, Zhou W, Wang K, Song W. Valproic Acid Inhibits Abeta Production, Neuritic Plaque Formation, and Behavioral Deficits in Alzheimer's Disease Mouse Models. The Journal of Experimental Medicine 2008; 205(12): 2781-2789. PubMed, doi: 10.1084/jem.20081588. Go to original source... Go to PubMed...
    26. Ramanan VK, Morris KA, Graff-Radford J, Jones DT, Burkholder DB, Britton JW, Josephs KA, Boeve BR, Savica R. Transient Epileptic Amnesia: A Treatable Cause of Spells Associated With Persistent Cognitive Symptoms. Frontiers in Neurology 2009; 10. Frontiers, doi: 10.3389/fneur.2019.00939. Go to original source... Go to PubMed...
    27. Rao SC, Dove G, Cascino GD, Petersen RC. Recurrent Seizures in Patients with Dementia: Frequency, Seizure Types, and Treatment Outcome. Epilepsy & Behavior: E&B 2009; 14(1): 118-120. PubMed, doi: 10.1016/j.yebeh.2008.08.012. Go to original source... Go to PubMed...
    28. Rudd GD, Haverkamp W, Mason JW, Wenger T, Jay G, Hebert D, Doty P, Horstmann R. Lacosamide Cardiac Safety: Clinical Trials in Patients with Partial-Onset Seizures. Acta Neurologica Scandinavica 2015; 132(5): 355-363. Wiley Online Library, doi: 10.1111/ane.12414. Go to original source... Go to PubMed...
    29. Salinsky M, Storzbach D, Munoz S. Cognitive Effects of Pregabalin in Healthy Volunteers: A Double-Blind, Placebo-Controlled Trial. Neurology 2010; 74(9): 755-761. Crossref, doi: 10.1212/WNL.0b013e3181d25b34. Go to original source... Go to PubMed...
    30. Sarkis RA, Nicolas J, Lee JW. Tolerability of Lacosamide or Zonisamide in Elderly Patients with Seizures. Seizure 2017; 49: 1-4. PubMed, doi: 10.1016/j.seizure.2017.04.010. Go to original source... Go to PubMed...
    31. Scarmeas N, Honig LS, Choi H, Cantero J, brandt J, Blacker D, Albert M, Amatniek JC, Marder K, Bell K, Hauser WA, Stern Y. Seizures in Alzheimer Disease: Who, When, and How Common? Archives of Neurology 2009; 66(8): 992-97. jamanetwork.com, doi: 10.1001/archneurol.2009.130. Go to original source... Go to PubMed...
    32. Seeck M, Koessler L, Bast T, Leijten F, Michel C, Baumartner C, He B, Beniczky S. The standardized EEG electrode array of the IFCN. Clinical Neurophysiology 2017; 128(10): 2070-77. ScienceDirect, doi: 10.1016/j.clinph.2017.06.254. Go to original source... Go to PubMed...
    33. Sheng JG, Boop FA, Mrak RE, Griffin WTS. Increased Neuronal β-Amyloid Precursor Protein Expression in Human Temporal Lobe Epilepsy: Association with Interleukin-1α Immunoreactivity. Journal of neurochemistry 1994; 63(5): 1872-79. Go to original source... Go to PubMed...
    34. Smith KM, Blessing MM, Parisi JE, Britton JW, Mandrekar J, Cascino GD. Tau Deposition in Young Adults with Drug-Resistant Focal Epilepsy. Epilepsia 2019; 60(12): 2398-403. PubMed, doi: 10.1111/epi.16375. Go to original source... Go to PubMed...
    35. Supasitthumrong T, Bolea-Alamanac BM, Asmer S, Woo VL, Abdool PS, Davies SJC. Gabapentin and Pregabalin to Treat Aggressivity in Dementia: A Systematic Review and Illustrative Case Report. British Journal of Clinical Pharmacology 2019; 85(4): 690-703. Wiley Online Library, doi: 10.1111/bcp.13844. Go to original source... Go to PubMed...
    36. Tariot PN, Schneider LS, Cummings J, Thomas RG, Raman R, Jakimovich LJ, Loy R, Bartocci B, Fleisher A, Ismail MS, Porteinsson A, Weiner M, Jack CR, Thal L, Aisen PS, Alzheimer´s Disease Study Group. Chronic Divalproex Sodium to Attenuate Agitation and Clinical Progression of Alzheimer Disease. Archives of General Psychiatry 2011; 68(8): 853-61. PubMed, doi: 10.1001/archgenpsychiatry.2011.72. Go to original source... Go to PubMed...
    37. Vossel KA, Beagle AJ, Rabinovici GD, Shu H, Lee SE, Naasan G, Hegde M, Cornes SB, Henry ML, Nelson AB, Seeley WW, Geschwind MD, Gorno-Tempini ML, Shih T, Kirsch HE, Garcia PA, Miller BL, Mucke L. Epileptic activity in Alzheimer's disease: causes and clinical relevance. The Lancet. Neurology 2017; 16(4): 311-322. PubMed Central, doi: 10.1016/S1474-4422(17)30044-3. Go to original source... Go to PubMed...
    38. Vossel KA, Ranasinghe KG, Beagle AJ, Mizuiri D, Honma SM, Dowling AF, Darwish SM, Van Berlo V, Barnes DE, Mantle M, Karydas AM, Coppola G, Roberson ED, Miller BL, Garcia PA? Kirsch HE, Mucke L, Nagarajan SS. Incidence and Impact of Subclinical Epileptiform Activity in Alzheimer's Disease. Annals of Neurology 2016; 80(6): 858-70. PubMed, doi: 10.1002/ana.24794. Go to original source... Go to PubMed...
    39. Vossel KA, Beagle AJ, et al. Seizures and Epileptiform Activity in the Early Stages of Alzheimer Disease. JAMA Neurology 2013; 70(9): 1158-66. PubMed, doi: 10.1001/jamaneurol.2013.136. Go to original source... Go to PubMed...
    40. Vyhnálek M, Bartoš A, Dostál V, Frankova V, Holmerová I, Laczó J, Línek V, Rektorová I, Ressner P, Rusina R, Sheardová K, Vališ M, Hort J. Diagnostikujeme a léčíme demence správně a včas? výsledky průzkumu ve světle nových doporučení. Neurol. praxi 2011; 12(5): 352-58.
    41. Xi, Z-Q, Wang XF, Shu XF, Xia F, SUn JJ, Zhu X. Is Intractable Epilepsy a Tauopathy? Medical Hypotheses 2011; 76(6): 897-900. PubMed, doi: 10.1016/j.mehy.2011.03.003. Go to original source... Go to PubMed...
    42. Zarea A, Charbonnier C, Rovelet-Lecrux A, Nicolas G, Rousseau S, Borden A, Pariente J, Le Ber I, Pasquier F, Formaglio M, Martinaud O, Rollin-Sillaire A, Sarazin M, Croisile B, Boutoleau-Bretonniere C, Ceccaldi M, Gabelle A, Chamard L, Vlanc, PHRC GMAJ Collaborants. Seizures in Dominantly Inherited Alzheimer Disease. Neurology 2016; 87(9): 912-19. PubMed, doi: 10.1212/WNL.0000000000003048. Go to original source... Go to PubMed...

    Return to the content


    Neurology for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.