F65. The converging path of Alzheimer’s disease and epilepsy: A prospective long-term EEG study

Abstract

Introduction Evidence suggests that patients with Alzheimer’s disease (AD) have a higher chance to develop epileptic seizures. However, results of prevalence studies are ambiguous and only a few studies observed the risk factors of seizures and the impact of epileptiform activity on the progression of cognitive deterioration. The appropriate neurophysiologic technique for accurate detection of dementia-related epilepsy is also questionable. Methods We selected 50 patients meeting the criteria for probable AD and followed them during 2 years. The patients underwent rigorous clinical investigation including long-term (24 h) EEG monitoring and repeated detailed neuropsychology. We analysed the prevalence of epileptic seizures and epileptiform activity, described the spatial and temporal distribution of epileptic discharges and the semiology of seizures. We also measured the sensitivity of different EEG lengths and the relation of interictal activity to different sleep stages. To analyse the risk factors of epilepsy, we compared patients with and without seizures from many epidemiology and clinical aspects with a covariance analysis. To define the effect of spike activity on the progression of cognitive decline, repeated measure general linear model was applied. Results We revealed epileptic seizures in quarter of the patients, mostly non-motor (55%), complex partial seizures with temporal lobe origin. Early onset of cognitive decline, long duration of dementia, more severe stage of AD and higher education were significant risk factors for developing seizures (p Conclusion Epilepsy is a common comorbidity of AD. Epileptic seizures predominantly occur in highly educated AD patients with early onset dementia at the severe stage of the disease. Epileptiform discharges could accelerate the progression of AD, so accurate assessment of AD-related epilepsy with long-term Holter-EEG including sleep recording is essential because antiepileptic drugs might represent a new therapeutic strategy in AD.