Alzheimer’s disease is a progressive neurological disorder that gradually impairs memory, thinking, and behavior. While not all individuals with Alzheimer’s experience seizures, a recognized link exists, meaning people with Alzheimer’s have an increased susceptibility. Understanding this relationship helps in recognizing and managing these events.
The Connection Between Alzheimer’s and Seizures
Seizures are more common in people with Alzheimer’s due to neurological changes that disrupt normal brain electrical activity. Neuronal hyperexcitability, where brain cells become overly active, is a significant factor. This abnormal activity can be induced by amyloid-beta, a protein that accumulates in the brain, forming plaques that hinder neuron function.
The buildup of amyloid-beta plaques and neurofibrillary tangles are hallmarks of Alzheimer’s disease. These protein aggregates affect how nerve cells communicate, leading to instability in brain networks. Brain inflammation, often caused by the immune system’s response to these protein buildups, further exacerbates neuronal dysfunction and contributes to seizure susceptibility. The risk of seizures can appear in early stages and increases as the disease progresses.
Identifying Seizures in Alzheimer’s
Recognizing seizures in individuals with Alzheimer’s can be challenging because they may present differently than typical seizures and can be mistaken for other symptoms of the disease. Convulsive seizures, like generalized tonic-clonic seizures, involve a loss of consciousness, body stiffening, and rhythmic jerking movements, which are generally noticeable. Many seizures in Alzheimer’s are non-convulsive, often focal onset seizures, affecting only one part of the brain.
These more subtle seizures can manifest as brief periods of unresponsiveness or increased amnesia. Caregivers might observe involuntary, repetitive movements, such as chewing, lip-smacking, or repetitive hand or arm movements. Sudden changes in behavior, staring spells, or confusion that are not typical for the individual’s baseline Alzheimer’s symptoms could also indicate a seizure.
Diagnosing Seizures in Alzheimer’s
Medical professionals rely on a combination of methods to diagnose seizures in individuals with Alzheimer’s. A detailed patient history, often provided by caregivers, is invaluable in describing observed behaviors and potential seizure events. This information guides the diagnostic process, as individuals with Alzheimer’s may not be able to accurately recall or describe their symptoms due to cognitive impairments.
A neurological examination helps assess overall brain function. Diagnostic tests, such as an electroencephalogram (EEG), measure brain electrical activity to detect abnormal patterns. Brain imaging, like magnetic resonance imaging (MRI), may also be performed to rule out other causes of seizure-like symptoms.
Treating Seizures in Alzheimer’s
Treating seizures in Alzheimer’s patients primarily involves anti-seizure medications (ASMs). Selecting ASMs requires careful consideration, especially in older adults with cognitive impairment, weighing benefits against potential side effects like drowsiness, dizziness, or cognitive worsening.
Dosage titration is a careful process, starting with a low dose and gradually increasing it to find the most effective amount with the fewest side effects. Non-pharmacological strategies also play a role, including ensuring the patient’s safety during a seizure by removing nearby objects and positioning them on their side if they are lying down.