Abstract
Purpose: To assess the prevalence and predictors of seizures in patients with Alzheimer’s disease (AD) at a Saudi tertiary hospital.Methods: A retrospective, matched case-control study was conducted using the electronic medical records of patients with AD who had an unprovoked seizure, from October 2015 to May 2018.Results: Nineteen cases and 195 controls were identified. Statistically significant risk factors for an unprovoked seizure in patients diagnosed with AD were hypertension (p = 0.001), autoimmune disease, stroke and TIA (p = 0.001). The multivariate logistic regression analysis identified hypertension (OR = 2.89; p = 0.009) and autoimmune disease (OR = 19.6; p = 0.045) as predictors of unprovoked seizure in AD patients.Conclusion: The occurrence of unprovoked seizures is more likely in severe cases of AD. In addition, the risk of seizure in patients with AD increases with two co-morbid conditions, hypertension, and autoimmune disease. However, further studies are required to determine the underlying mechanism of the association between the two risk factors and AD.
Highlights
Alzheimer’s disease (AD) is one of the most common neurodegenerative disorders known among older patients [1]
In Saudi Arabia, there are no official statistics related to the prevalence of AD, but according to the Saudi Ministry of Health, the estimated number of AD cases are at least 50,000, most of whom are women [2]
Amatniek et al found that the risk of developing unprovoked seizure was 87-fold higher in younger patients, while it was more than 3-fold higher in the older group compared to the known AD age group [6]
Summary
Alzheimer’s disease (AD) is one of the most common neurodegenerative disorders known among older patients [1]. Several risk factors have been linked to AD which include aging, smoking, cardiovascular diseases, stroke/transient ischemic attack (TIA), Some previous studies have linked the late stages of AD with unprovoked seizures [3,4]. It is estimated that the prevalence of seizures in AD patients can reach up to 64 % [5]. While the predictors of an unprovoked seizure in AD patients include a younger age, severe dementia, focal epileptiform findings from an electroencephalogram (EEG) and an African American ethnicity [6]. Amatniek et al found that the risk of developing unprovoked seizure was 87-fold higher in younger patients, while it was more than 3-fold higher in the older group compared to the known AD age group [6]. Hauser et al found that patients with AD are at higher risk of developing seizures and epilepsy [4]
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