This data demonstrates that patients with Alzheimer disease are at an increased risk for seizures, in particular in more advanced disease stages, which emphasizes a need for seizure history assessment to inform individual therapeutic decisions and the necessity of systematic treatment studies.
"The prevalence of seizures in Alzheimer patients could be underestimated; one reason could be that at least to my experience, these are rarely the main complaint of patients with Alzheimer disease but rather memory problems or other cognitive complaints."
At the 2019 Alzheimer’s Association International Conference, held in Los Angeles, California, Jonathan Vöglein, MD, of the German Center for Neurodegenerative Diseases and Ludwig-Maximilian University in Munich, presented results from an analysis of data from the National Alzheimer’s Coordinating Center, which found that the prevalence of active seizures was higher in those with Alzheimer disease than those without the disease (1.51% vs. 0.35%, P <.0001), and that those with Alzheimer disease were twice as likely to have had a previous seizure (3.14% vs. 1.57%, P <.0001).
Data from 20745 individuals were available. The prevalence of active seizures rose with duration of Alzheimer disease (P <.0001), from 1.51% at 4.8 years of disease duration to 5.43% at 11 years. Seizure history was associated with a younger age of onset of cognitive symptoms (seizures vs. no seizures: 64.7 vs. 70.4 years; P <.0001) and worse cognitive and functional performance.
According to the investigators, 1 seizure in patients with Alzheimer disease could lead to a diagnosis of epilepsy according to current guidelines and may implicate an antiepileptic treatment. Seizure history should be assessed in order to inform therapeutic decisions.
To speak further about this data and its implication, NeurologyLive spoke with Vöglein in an interview at the meeting.
For more coverage of AAIC 2019, click here.
Voglein J, Ricard I, Noachtar S, et al. Epilepsy in Alzheimer Disease Is Frequent and Characterized By High Recurrence. Presented at: 2019 Alzheimer’s Association International Conference, Los Angeles, CA, July 14—18, 2019.