Individuals living with dementia can experience seizures. Recognizing and addressing these seizures is important for caregivers and family members, as it significantly impacts the well-being of those affected. The relationship between dementia and seizures is complex, stemming from underlying brain changes.
Understanding the Connection
Brain changes associated with various forms of dementia can increase seizure susceptibility. As brain cells are damaged, the delicate balance of electrical activity can be disrupted, making neurons more excitable and prone to uncontrolled firing. In Alzheimer’s disease (AD), for instance, abnormal proteins like amyloid-beta plaques and tau tangles directly affect neuronal communication, contributing to this hyperexcitability.
Different types of dementia carry varying seizure risks. People with Alzheimer’s disease have a higher risk of seizures compared to those without dementia, with incidence typically ranging from 1.5% to 5.4%. This risk often increases with the disease’s duration and severity.
Vascular dementia, caused by compromised blood flow and damage to brain vessels, also elevates seizure risk. Lewy body dementia, characterized by protein clumps in nerve cells, also presents an increased seizure risk.
Identifying Seizures in Dementia
Recognizing seizures in individuals with dementia can be challenging, as their manifestations may differ from typical presentations and be mistaken for dementia symptoms. Seizures can manifest as subtle changes in behavior or awareness rather than dramatic convulsions. Both generalized seizures, affecting both sides of the brain, and focal seizures, originating in one part, are common.
Subtle signs of focal seizures might include brief confusion, unresponsiveness, repetitive movements (like lip-smacking or fumbling), and unusual sensations. Generalized seizures can involve body-wide jerking, stiffening, or loss of consciousness. However, these may be less obvious in individuals with cognitive impairment. Caregivers should note staring spells, sudden confusion, drowsiness, unexplained aggression, or mood shifts. The elusive nature of these symptoms means seizures are often missed or attributed to dementia progression, making careful observation and detailed reporting crucial.
Diagnosing and Treating Seizures
Diagnosing seizures in individuals with dementia involves a comprehensive medical evaluation due to subtle presentations and overlap with dementia symptoms. Electroencephalography (EEG) is a primary diagnostic tool, recording the brain’s electrical activity to identify abnormal patterns characteristic of seizures. Brain imaging techniques like Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans are also used to identify structural changes that might contribute to seizures or rule out other underlying causes like tumors or strokes.
Treatment for seizures in dementia typically involves anti-epileptic medications (ASMs). Medication choice considers seizure type, potential drug interactions, and side effects, especially since older adults with dementia often take multiple medications.
Newer ASMs, like levetiracetam and lamotrigine, are often preferred as first-line treatments due to lower potential for drug interactions and fewer adverse cognitive effects compared to older medications. While some studies suggest continuous use of certain ASMs can be associated with increased dementia risk, this is primarily linked to older medications known to impair cognitive function.
Managing seizures can improve cognitive function and overall quality of life. Consulting a healthcare professional is important for proper diagnosis and management, as early recognition and appropriate treatment can help mitigate the impact of seizures on health and cognitive decline.