a Unité de Neuropsychologie , Service de Neurologie des Hôpitaux Universitaires de Strasbourg , Strasbourg , France.
b Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar) , Strasbourg , France.
Expert Opin Pharmacother. 2018 Aug;19(11):1201-1209. doi: 10.1080/14656566.2018.1496237. Epub 2018 Jul 14.
Alzheimer's disease (AD)-related epileptic comorbidity is now well documented and appears to have been previously underestimated. Prescribing antiepileptic drugs (AEDs) in AD patients aims at preventing seizure-related morbi-mortality and the occurrence of deleterious status epilepticus. At the earlier stages of the disease, some clinicians even expect a disease-modifying effect.
In this review, the author provides a brief overview of the epileptic comorbidity in AD, discusses the appropriate AEDs from a syndromic point of view, reviews the effectiveness and cognitive tolerability of the currently available drugs, and considers the influence of the comorbidities and the age of AD patients in the choice of an AED.
Given the paucity of current empirical data, much remains to be done to provide good evidence of the efficacy and tolerability of AEDs in the area of AD-related seizures and epilepsy. To our knowledge, lamotrigine and levetiracetam are currently the two best therapeutic options as low-dose monotherapies.
阿尔茨海默病（AD）相关的癫痫共病现在已有充分的记录，并似乎以前被低估了。在 AD 患者中开抗癫痫药物（AED）的目的是预防与癫痫相关的发病率和死亡率以及有害的癫痫持续状态的发生。在疾病的早期阶段，一些临床医生甚至期望有疾病修饰作用。
在这篇综述中，作者简要概述了 AD 中的癫痫共病，从综合征的角度讨论了适当的 AED，回顾了目前可用药物的有效性和认知耐受性，并考虑了共病和 AD 患者年龄对 AED 选择的影响。
鉴于目前实证数据的缺乏，在 AD 相关癫痫发作和癫痫领域提供 AED 的疗效和耐受性的良好证据仍有许多工作要做。据我们所知，拉莫三嗪和左乙拉西坦目前是两种作为低剂量单药治疗的最佳治疗选择。
