Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Yadman Center of Cognitive Disorders, Tehran, Iran.
Am J Alzheimers Dis Other Demen. 2019 Mar;34(2):81-88. doi: 10.1177/1533317518813551. Epub 2018 Dec 30.
Alzheimer's disease (AD) is considered as a potential risk factor for the development of seizure due to neurodegeneration and imbalance between stimulatory and inhibitory circuits in the brain. Seizure could occur in any point during the course of AD, and its presentation varies from fluctuation in cognitive domains to more typical seizures. The clinical diagnosis of seizure in patients with dementia may be challenging due to difficulty in history taking and clinical assessment. No paraclinic methods other than electroencephalogram (EEG) could provide arguments for the diagnosis of AD-related seizures (neither imaging modalities nor cerebrospinal fluid biomarkers). Standard 30-minute EEG may not be sufficiently sensitive to detect epileptiform discharges. In the present study, we aim to review different aspects of seizure in AD, including seizure prevalence, risk factors, underlying mechanisms, electroencephalographic findings, clinical presentations, impact of seizures on AD, and treatment options.
阿尔茨海默病(AD)被认为是癫痫发作的潜在危险因素,这是由于大脑中的神经退行性变和兴奋与抑制回路之间的失衡所致。癫痫发作可能发生在 AD 病程的任何阶段,其表现从认知领域的波动到更典型的癫痫发作不等。由于病史采集和临床评估困难,痴呆患者癫痫发作的临床诊断可能具有挑战性。除了脑电图(EEG)之外,没有其他辅助检查方法可以为 AD 相关癫痫发作的诊断提供依据(影像学方法和脑脊液生物标志物均不行)。标准的 30 分钟 EEG 可能不足以检测到癫痫样放电。在本研究中,我们旨在综述 AD 中癫痫发作的不同方面,包括癫痫发作的患病率、危险因素、潜在机制、脑电图表现、临床表现、癫痫发作对 AD 的影响以及治疗选择。