Seizures and epileptiform activity in the early stages of Alzheimer disease.

ABSTRACT: Epileptic activity associated with Alzheimer disease (AD) deserves increased attention because it has a harmful impact on these patients, can easily go unrecognized and untreated, and may reflect pathogenic processes that also contribute to other aspects of the illness. We report key features of AD-related seizures and epileptiform activity that are instructive for clinical practice and highlight similarities between AD and transgenic animal models of the disease.To describe common clinical characteristics and treatment outcomes of patients with amnestic mild cognitive impairment (aMCI) or early AD who also have epilepsy or subclinical epileptiform activity.Retrospective observational study from 2007 to 2012. SETTING Memory and Aging Center, University of California, San Francisco.We studied 54 patients with a diagnosis of aMCI plus epilepsy (n = 12), AD plus epilepsy (n?=?35), and AD plus subclinical epileptiform activity (n?=?7).Clinical and demographic data, electroencephalogram (EEG) readings, and treatment responses to antiepileptic medications.Patients with aMCI who had epilepsy presented with symptoms of cognitive decline 6.8 years earlier than patients with aMCI who did not have epilepsy (64.3 vs 71.1 years; P?=?.02). Patients with AD who had epilepsy presented with cognitive decline 5.5 years earlier than patients with AD who did not have epilepsy (64.8 vs 70.3 years; P?=?.001). Patients with AD who had subclinical epileptiform activity also had an early onset of cognitive decline (58.9 years). The timing of seizure onset in patients with aMCI and AD was nonuniform (P?

SUBMITTER: Vossel KA 

PROVIDER: S-EPMC4013391 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature