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Epilepsy and Dementia in the ElderlyHommet C.a, b · Mondon K.b, c · Camus V.b, c · De Toffol B.d · Constans T.a
aGeriatric Internal Medicine and Regional Memory Centre, bInserm Unit 619, cRegional Memory Centre and dNeurology Unit, University Hospital, Tours University, Tours, France Corresponding Author
Caroline Hommet, MD, PhD
Geriatric Internal Medicine and Regional Memory Centre, University Hospital
FR–37044 Tours Cedex (France)
Tel. +33 2 47 47 37 13, Fax +33 2 47 47 60 14, E-Mail email@example.com
Epilepsy is a frequent condition in the elderly; however, it remains a relatively understudied condition in older adults with dementia. The diagnosis of a seizure is particularly difficult and is most often based on questions to the caregiver. Epilepsy in dementia has significant consequences on the prognosis of the underlying dementia: it can result in a worsening of cognitive performance, particularly in language, as well as a reduction in autonomy, a greater risk of injury and a higher mortality rate. In this review, management strategies are recommended for the clinician. The presence of pre-existing Alzheimer’s disease does not exempt the clinician from ruling out other symptomatic causes of seizures. Anti-epileptic drugs (AED) should be started only after the diagnosis has been clearly established, when the risk of recurrence is high, and with monotherapy whenever possible. Although few data are available, the more recent AED offer significant advantages over the older medications in this context.
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