Abstract
Purpose
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.
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References
Amatniek JC, Hauser WA, DelCastillo-Castaneda C, et al. Incidence and Predictors of Seizure in Patients with Alzheimer’s Disease. Epilepsia 2006;47:867–872.
Commission on Classification and Terminology of the International League against Epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia 1981;22:489–501.
Forsgren L, Bucht G, Eriksson S, Bergmark L. Incidence and Clinical Characterization of Unprovoked Seizures in Adults: a Prospective Population-Based Study. Epilepsia 1996;37:224–229.
Förstl H, Burns A, Levy R, Cairns N, Luthert P, Lantos P. Neurologic Signs in Alzheimer Disease. Results of a Prospective Clinical and Neuropathological Study. Archives of Neurology 1992;49:1038–1042.
Hauser WA, Morris ML, Heston LL, Anderson VE. Seizures and myoclonus in patients with Alzheimer’s disease. Neurology 1986;36:1226–1230.
Hersdoffer DC, Hauser WA, Annegers JF, Kokmen E, Rocca WA. Dementia and adult onset unprovoked seizures. Neurology 1996;46:727–730.
Höglund K, Blennow K. Effect of HMG-CoA reductase inhibitors on beta-amyloid peptide levels: implication for Alzheimer’s disease. CNS Drugs 2007;21:449–462.
Hommet C, Mondon K, Camus V, De Toffol B, Constans T. Epilepsia and Dementia in the Elderly. Dementia Geriatric and Cognitive Disorders 2008;25:293–300.
Lozsadi DA, Larner AJ. Prevalence and Causes of Seizures at the Time of Diagnosis of Probable Alzheimer’s Disease. Dementia and Geriatric Cognitive Disorders 2006;22:121–124.
McKhann G, Drochman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s Disease: Report of the NINCDS-ADRDA Work Group under the auspices of department of health and human services task force on Alzheimer’s Disease. Neurology 1984;34:939–944.
McAreavey MJ, Ballinger BR, Fenton GW. Epileptic Seizures in Elderly Patients with Dementia. Epilepsia 1992;33:657–660.
Mendez MF, Lim GTH. Seizures in Elderly Patients with Dementia. Drugs Aging 2003;20:791–803.
Menendez M. Down syndrome, Alzheimer’s disease and seizures. Brain & Development 2005;27:246–252.
Petersen RC, Doody R, Kurz A. Current concepts in mild cognitive impairment. Archives of Neurology 2001;58:1985–1992.
Randall JB, Pleumer S, Scandura D. Incidence of Seizure in a Residential Alzheimer care facility. Epilepsia 1995; 36(Suppl. 3):S244.
Risse SC, Lampe TH, Bird TD, et al. Myoclonus, Seizures and Paratonia in Alzheimer Disease. Alzheimer Disease and Associated Disorders 1990;4:217–225.
Romanelli MF, Morris JC, Ashkin K, Coben LA. Advanced Alzheimer’s Disease is a Risk Factor for Late Onset Seizures. Archives of Neurology 1990;47:847–850.
Silverman EI, Restrepo L, Mathews GC. Poststroke Seizures. Archives of Neurology 2002;59:195–201.
Sjögren M, Mielke M, Gustafson D, Zandi P, Skoog I. Cholesterol and Alzheimer Disease: is there a relation. Mechanism of aging and development 2006;127:138–147.
Tris Oman GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993;43:250–260.
Volicer L, Smith S, Volicer B. Effect of Seizures on Progression of Dementia of the Alzheimer Type. Dementia 1995;6:258–263.
Wang J, Ho L, Chen L, et al. Valsartan lowers brain beta-amyloid protein levels and improves spatial learning in a mouse model of Alzheimer disease. Journal of Clinical Investigation 2007;117:3393–3402.
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Bernardi, S., Scaldaferri, N., Vanacore, N. et al. Seizures in Alzheimer’s disease: a retrospective study of a cohort of outpatients. Epileptic Disord 12, 16–21 (2010). https://doi.org/10.1684/epd.2010.0290
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DOI: https://doi.org/10.1684/epd.2010.0290