Prevalence, Semiology, and Risk Factors of Epilepsy in Alzheimer's Disease: An Ambulatory EEG Study
Prevalence, Semiology, and Risk Factors of Epilepsy in Alzheimer's Disease: An Ambulatory EEG Study
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DOI：
10.3233/jad-170925
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发表时间：
2018-01-01
影响因子：
4
通讯作者：
Kamondi, Anita
中科院分区：
文献类型：
--
作者：
Horvath, Andras;Szucs, Anna;Kamondi, Anita
背景：阿尔茨海默病（AD）是认知功能下降的主要原因。越来越多的证据表明，AD患者有更高的风险发展癫痫发作，然而，结果是矛盾的，由于不同的方法论的方法，以前的study.Objective：我们的目的是确定的患病率，症状学，和癫痫的危险因素，在AD使用长期EEG.Methods：我们选择了42例AD患者，并检查他们使用24小时动态脑电图。采用回顾性和前瞻性方法收集神经病学和癫痫学资料。结果：24%的癫痫患者经脑电图检查证实为癫痫发作，其中24%的癫痫患者经脑电图检查证实为癫痫发作。大多数癫痫发作是有意识的局灶性（72%），没有任何运动活动（55%）。我们发现28%的患者有癫痫样放电而无癫痫发作。癫痫发作和癫痫性脑电图活动的患者表现出相似的临床和人口统计学特征。高学历（OR：1.8）和低Addenbrooke考试评分（OR：0.9）被确定为癫痫的危险因素。言语语言/定向记忆比率（VLOM）每增加0.1分，癫痫发生的危险性也增加（OR：2.9）。由于大多数癫痫发作是意识性非运动性局灶性发作，因此需要灵敏的脑电图技术来精确诊断癫痫。长期动态EEG是一种安全且耐受性良好的选择。AD患者的癫痫样EEG提示存在伴随癫痫。高文化程度、VLOM比例高、病情重的痴呆患者中癫痫共病应引起临床医师的重视。
Background: Alzheimer's disease (AD) is the primary cause of cognitive decline. A growing body of evidence suggests that ADpatients have a higher risk to develop epileptic seizures; however, results are contradictory due to different methodological approaches of previous studies.Objective: We aimed to identify the prevalence, semiology, and risk factors of epilepsy in AD using long-term EEG.Methods: We selected forty-two AD patients and examined them using 24-hour ambulatory EEG. Neurological and epileptological data were collected with retro- and prospective methods. We analyzed the semiology of the identified seizures and the possible risk factors using logistic regression analysis.Results: We identified seizures confirmed by EEG in 24%. The majority of the seizures were aware focal (72%) without any motor activity (55%). We found epileptiform discharges without seizures in 28%. Patients with seizures and only with epileptic EEG activity showed similar clinical and demographical features. Higher education (OR: 1.8) and lower Addenbrooke Examination Score (OR: 0.9) were identified as risk factors of epilepsy. Increase of 0.1 point in the Verbal-Language/Orientation-Memory ratio (VLOM) was associated with higher epilepsy risk as well (OR: 2.9).Conclusion: Epilepsy is a frequent comorbidity of AD. Since most of the seizures are aware non-motor focal seizures, sensitive EEG techniques are required for precise diagnosis of epilepsy. Long-term ambulatory EEG is a safe and welltolerated option. Epileptiform EEG in AD signals the presence of concomitant epilepsy. Clinicians have to pay attention to comorbid epilepsy in dementia patients with high education, with high VLOM ratio and severe stage.