Epileptic Amnesia as an Alzheimer’s Disease Mimic (P2-6.004)

Abstract

<h3>Objective:</h3> To present a case of amnestic dementia that was caused as a result of mesial temporal lobe epilepsy. <h3>Background:</h3> Memory impairments have been reported as a result of mesial temporal lobe epilepsy. Dementia as a result of long term uncontrolled seizures has been reported. Here we report a patient presenting for evaluation of dementia - diagnosed with uncontrolled mesial temporal lobe epilepsy. <h3>Design/Methods:</h3> A 76 year old male presented to the cognitive clinic for evaluation of amnestic problems that started approximately 4 years prior. The patient reported problems with both long-term and short-term memory–such as details of family vacations, weddings, names of acquaintances. He additionally reported mild word finding abnormalities and spatial difficulty. Neuropsychological testing revealed problems in non contextual verbal learning and memory. The patient notably reported stereotyped events which also started around 4 years prior.–which he described as getting a sense of deja vu followed by tingling in all 4 limbs, nausea and a changed sense of smell. These events occurred around 10 times a month. MRI brain performed 4 years prior had revealed some small vessel ischemic changes and diffuse volume loss. An EEG obtained at the time had been unremarkable. Repeat MRI brain was significant for left hippocampal atrophy with bilateral hippocampal T2 signal hyperintensities. Ambulatory EEG monitoring was significant for transient epileptiform discharges. Lumbar puncture was unremarkable with tau /amyloid profiles not consistent with Alzheimer9s pathology. The patient was started on Levetiracetam with cessation of his episodes of deja vu, tingling and nausea. <h3>Results:</h3> NA <h3>Conclusions:</h3> Uncontrolled mesial temporal lobe epilepsy can result in hippocampal atrophy and cause amnestic problems. Epilepsy should be a diagnostic consideration in patients who present for evaluation of dementia. <b>Disclosure:</b> Dr. Philip has nothing to disclose. Dr. Chabrashvili has nothing to disclose.