Abstracts

To investigate the seizure-type(s),EEG findings and seizure outcome in patients with Alzheimer[rsquo]s and other dementias.
We performed a retrospective analysis of patients with seizure disorders related to a dementia,who were identified using the Mayo Alzheimer[rsquo]s Dementia Patient Registry. The mean age was 81 years(range 57-97). The mean age of onset for seizures was 74 years (50-89 years). Routine EEG studies with standard activating procedures were performed in all 20 patients.
There were 20 patients identified. The etiology for the primary degenerative disorder was Alzheimer[rsquo]s dementia in 15 patients(75%); Multi infarct dementia in 3 patients(15 %) and Diffuse Lewy Body dementia in 2 patients( 10%). The seizure-type(s) included: complex partial seizures in 10 (50%) patients, generalized tonic- clonic seizures in 5(25%) patients and myoclonus in 4 patients. Ten of the 15(66%) patients with Alzheimer[rsquo]s dementia had partial seizures of temporal lobe origin. All 3 patients with multiinfarct dementia had partial epilepsy with the localization of seizure onset intimately associated with a region of cerebral infarction.
The routine EEG revealed unilateral temporal lobe spikes or electrographic seizures in 10 (50%) patients, extratemporal spikes in 2 (10%) of patients; multifocal PLEDs and Generalized atypical spike and wave in one patient respectively. Four patients had normal EEG recordings. All 16 patients with localization-related seizure disorder had a favorable response to antiepileptic drug therapy. All 4 patients with myoclonus were medically refractory.
The results of the present study may prove useful in counseling patients and their families with dementia and recurrent seizure activity. Most individuals with Alzheimer[rsquo]s dementia had partial seizures of temporal lobe origin that responded favorably to antiepileptic drug therapy