The prevalence of Alzheimer’s disease (AD) increases with age, and there is evidence that there is a close relationship between AD and epilepsy, with the incidence of epilepsy in AD patients being 1.5%-64%, 6-10 times higher than in healthy people of the same age, with patients with early onset AD being more likely to develop epilepsy. The incidence of epilepsy has been reported to be 1.5%-16% in patients with mild AD, and 95%-64% in patients with moderate to advanced dementia. Other AD patients with diabetes mellitus, hypertension, and use of antipsychotic drugs are also important predisposing factors.
The relationship between neuronal loss, hippocampal atrophy and epilepsy has been described in hippocampal sclerosis, the CA1 region of the hippocampus and the mycelial layer, and the onset of epilepsy in the thorax.
3, genetic factors: in autosomal dominant AD, progerin-1 (PS1), progerin-2 (PS2) and other genetic mutations are associated with seizures.
4. ApoE4: ApoE gene is located on chromosome 19 and is predominantly E3 in normal individuals. The frequency of E4 is significantly higher in AD patients, and its carriers are now thought to have a higher incidence of epilepsy.
5. Inflammatory factors may be one of the important factors for seizures in AD patients. Treatment: It mainly refers to the selection of antiepileptic drugs (AED). The selection of drugs needs to take into account the altered pharmacokinetics, adverse drug reactions, and drug-drug interactions in elderly patients. Therefore, in the absence of major differences in efficacy, new non-enzymatic induction AEDs should be preferred. Secondly, care should be taken to prevent further cognitive impairment and to be aware that some drugs for dementia may aggravate the occurrence of epilepsy.