Patients with epilepsy who had amnestic mild cognitive impairment (aMCI) or Alzheimer disease (AD) presented earlier with cognitive decline than patients who did not have epilepsy, according to a report published by JAMA Neurology, a JAMA Network publication.
AD increases a patient's risk of risk of seizures, and patients with AD and seizure disorders have greater cognitive impairment, more rapid progression of symptoms and more severe neuronal loss at autopsy than those without seizures, according to the study background.
"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," authors note in the study by Keith A. Vossel, M.D., M.Sc., of the Gladstone Institute of Neurological Disease, San Francisco, Calif., and colleagues.
The study included 54 patients with a diagnosis of aMCI plus epilepsy (n=12), AD plus epilepsy (n=35) and AD plus subclinical epileptiform activity (n=7).
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). 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), according to the results.
"Careful identification and treatment of epilepsy in such patients may improve their clinical course," the study concludes.
- Vossel KA, Beagle AJ, Rabinovici GD, et al. Seizures and Epileptiform Activity in the Early Stages of Alzheimer Disease. JAMA Neurology, 2013; DOI: 10.1001/jamaneurol.2013.136
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