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Table of Contents
Vol. 25, No. 4, 2008
Issue release date: April 2008
Section title: Review Article
Dement Geriatr Cogn Disord 2008;25:293–300

Epilepsy and Dementia in the Elderly

Hommet 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
email Corresponding Author

Caroline Hommet, MD, PhD

Geriatric Internal Medicine and Regional Memory Centre, University Hospital

Blvd Tonnellé

FR–37044 Tours Cedex (France)

Tel. +33 2 47 47 37 13, Fax +33 2 47 47 60 14, E-Mail hommet@med.univ-tours.fr


  1. Ramaroson H, Helmer C, Barberger-Gateau P, Letenneur L, Dartigues JF: Prevalence of dementia and Alzheimer’s disease among subjects aged 75 years or over: updated results of the PAQUID cohort. Rev Neurol (Paris) 2003;159:405–411.
  2. Helmer C, Peres K, Letenneur L, Guttierez-Robledo LM, Ramaroson H, Barberger-Gateau P, Fabrigoule C, Orgogozo JM, Dartigues JF: Dementia in subjects aged 75 years or over within the PAQUID cohort: prevalence and burden by severity. Dement Geriatr Cogn Disord 2006;22:87–94.
  3. De Ronchi D, Berardi D, Menchetti M, Ferrari G, Serretti A, Dalmonte E, Fratiglioni L: Occurrence of cognitive impairment and dementia after the age of 60: a population-based study from Northern Italy. Dement Geriatr Cogn Disord 2005;19:97–105.
  4. Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, Copeland JR, Dartigues JF, Jagger C, Martinez-Lage J, et al: Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology 2000;54:S4–S9.
  5. International League against Epilepsy: ILAE Commission report: the epidemiology of the epilepsies – future directions. Epilepsia 1997;38:614–618.
  6. Hauser WA, Annegers JF, Kurland LT: Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935–1984. Epilepsia 1993;34:453–468.
  7. Hauser WA, Annegers JF, Rocca WA: Descriptive epidemiology of epilepsy: contributions of population-based studies from Rochester, Minnesota. Mayo Clin Proc 1996;71:576–586.
  8. Granger N, Convers P, Beauchet O, Imler D, Viallon A, Laurent B, Michel D: First epileptic seizure in the elderly: electroclinical and etiological data in 341 patients. Rev Neurol (Paris) 2002;158:1088–1095.
  9. Mendez M, Lim G: Seizures in elderly patients with dementia: epidemiology and management. Drugs Aging 2003;20:791–803.
  10. Hauser WA, Morris ML, Heston LL, Anderson VE: Seizures and myoclonus in patients with Alzheimer’s disease. Neurology 1986;36:1226–1230.
  11. Mendez MF, Catanzaro P, Doss RC, Arguello R, Frey WH 2nd: Seizures in Alzheimer’s disease: clinicopathologic study. J Geriatr Psychiatry Neurol 1994;7:230–233.
  12. Romanelli MF, Morris JC, Ashkin K, Coben LA: Advanced Alzheimer’s disease is a risk factor for late-onset seizures. Arch Neurol 1990;47:847–850.
  13. McAreavey MJ, Ballinger BR, Fenton GW: Epileptic seizures in elderly patients with dementia. Epilepsia 1992;33:657–660.
  14. Stephen LJ, Brodie MJ: Epilepsy in elderly people. Lancet 2000;355:1441–1446.
  15. Hauser WA: Seizure disorders: the changes with age. Epilepsia 1992;33(suppl 4):S6–S14.
    External Resources
  16. Faught E: Epidemiology and drug treatment of epilepsy in elderly people. Drugs Aging 1999;15:255–269.
  17. Luhdorf K, Jensen LK, Plesner AM: Epilepsy in the elderly: prognosis. Acta Neurol Scand 1986;74:409–415.
  18. De la Court A, Breteler MM, Meinardi H, Hauser WA, Hofman A: Prevalence of epilepsy in the elderly: the Rotterdam Study. Epilepsia 1996;37:141–147.
  19. Hesdorffer DC, Hauser WA, Annegers JF, Kokmen E, Rocca WA: Dementia and adult-onset unprovoked seizures. Neurology 1996;46:727–730.
  20. Jallon P, Loiseau P, Loiseau J: Newly diagnosed unprovoked epileptic seizures: presentation at diagnosis in CAROLE study. Coordination Active du Réseau Observatoire Longitudinal de l’Epilepsie. Epilepsia 2001;42:464–475.
  21. Loiseau J, Loiseau P, Duche B, Guyot M, Dartigues JF, Aublet B: A survey of epileptic disorders in southwest France: seizures in elderly patients. Ann Neurol 1990;27:232–237.
  22. Armon C, Peterson GW, Liwnicz BH: Alzheimer’s disease underlies some cases of complex partial status epilepticus. J Clin Neurophysiol 2000;17:511–518.
  23. Rabinowicz AL, Starkstein SE, Leiguarda RC, Coleman AE: Transient epileptic amnesia in dementia: a treatable unrecognized cause of episodic amnestic wandering. Alzheimer Dis Assoc Disord 2000;14:231–233.
  24. Thomas RJ: Seizures and epilepsy in the elderly. Arch Intern Med 1997;157:605–617.
  25. Quinette P, Guillery-Girard B, Dayan J, de la Sayette V, Marquis S, Viader F, Desgranges B, Eustache F: What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 2006;129:1640–1658.
  26. Hodges JR, Warlow CP: Syndromes of transient amnesia: towards a classification. A study of 153 cases. J Neurol Neurosurg Psychiatry 1990;53:834–843.
  27. Gallassi R: Epileptic amnesic syndrome: an update and further considerations. Epilepsia 2006;47(suppl 2):103–105.
  28. Kapur N: Transient epileptic amnesia – a clinical update and a reformulation. J Neurol Neurosurg Psychiatry 1993;56:1184–1190.
  29. Brodie MJ, Kwan P: Epilepsy in elderly people. BMJ 2005;331:1317–1322.
  30. Ramsay RE, Rowan AJ, Pryor FM: Special considerations in treating the elderly patient with epilepsy. Neurology 2004;62:S24–S29.
  31. Centorrino F, Goren JL, Hennen J, Salvatore P, Kelleher JP, Baldessarini RJ: Multiple versus single antipsychotic agents for hospitalized psychiatric patients: case-control study of risks versus benefits. Am J Psychiatry 2004;161:700–706.
  32. Babic T, Zurak N: Convulsions induced by donepezil. J Neurol Neurosurg Psychiatry 1999;66:410.
  33. Piecoro LT, Wermeling DP, Schmitt FA, Ashford JW: Seizures in patients receiving concomitant antimuscarinics and acetylcholinesterase inhibitor. Pharmacotherapy 1998;18:1129–1132.
  34. Van Cott AC: Epilepsy and EEG in the elderly. Epilepsia 2002;43:94.
  35. Holmes GL: The electroencephalogram as a predictor of seizures following cerebral infarction. Clin Electroencephalogr 1980;11:83–86.
  36. Sirven JI: Epilepsy in older adults: causes, consequences and treatment. J Am Geriatr Soc 1998;46:1291–1301.
  37. Vercueil L: Epilepsy and neurodegenerative diseases in adults: a clinical review. Epileptic Disord 2006;8:S44–S54.
    External Resources
  38. Commission on classification and terminology of the International League against Epilepsy: proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989;3:389–399.
  39. Risse SC, Lampe TH, Bird TD, Nochlin D, Sumi SM, Keenan T, Cubberley L, Peskind E, Raskind MA: Myoclonus, seizures, and paratonia in Alzheimer disease. Alzheimer Dis Assoc Disord 1990;4:217–225.
  40. Amatniek JC, Hauser WA, Del Castillo-Castaneda C, Jacobs DM, Marder K, Bell K, Albert M, Brandt J, Stern Y: Incidence and predictors of seizures in patients with Alzheimer’s disease. Epilepsia 2006;47:867–872.
  41. Takao M, Ghetti B, Murrell JR, Unverzagt FW, Giaccone G, Tagliavini F, Bugiani O, Piccardo P, Hulette CM, Crain BJ, et al: Ectopic white matter neurons, a developmental abnormality that may be caused by the PSEN1 S169L mutation in a case of familial AD with myoclonus and seizures. J Neuropathol Exp Neurol 2001;60:1137–1152.
  42. Velez-Pardo C, Arellano JI, Cardona-Gomez P, Jimenez Del Rio M, Lopera F, De Felipe J: CA1 hippocampal neuronal loss in familial Alzheimer’s disease presenilin-1 E280A mutation is related to epilepsy. Epilepsia 2004;45:751–756.
  43. Ezquerra M, Carnero C, Blesa R, Gelpi JL, Ballesta F, Oliva R: A presenilin 1 mutation (Ser169Pro) associated with early-onset AD and myoclonic seizures. Neurology 1999;52:566–570.
  44. Forstl H, Burns A, Levy R, Cairns N, Luthert P, Lantos P: Neurologic signs in Alzheimer’s disease. Results of a prospective clinical and neuropathologic study. Arch Neurol 1992;49:1038–1042.
  45. Mikolaenko I, Conner MG, Jinnah HA: A 50-year-old man with acute-onset generalized seizure. Cerebral amyloid angiopathy and associated giant cell reaction. Arch Pathol Lab Med 2006;130:e5–e7.
    External Resources
  46. Shrimpton AE, Schelper RL, Linke RP, Hardy J, Crook R, Dickson DW, Ishizawa T, Davis RL: A presenilin 1 mutation (L420R) in a family with early onset Alzheimer disease, seizures and cotton wool plaques, but not spastic paraparesis. Neuropathology 2007;27:228–232.
  47. Ala TA, Beh GO, Frey WH 2nd: Pure hippocampal sclerosis: a rare cause of dementia mimicking Alzheimer’s disease. Neurology 2000;54:843–848.
  48. Luhdorf K, Jensen LK, Plesner AM: Etiology of seizures in the elderly. Epilepsia 1986;27:458–463.
  49. Chandra V, Bharucha NE, Schoenberg BS: Conditions associated with Alzheimer’s disease at death: case-control study. Neurology 1986;36:209–211.
  50. Volicer L, Smith S, Volicer BJ: Effect of seizures on progression of dementia of the Alzheimer type. Dementia 1995;6:258–263.
  51. Aarts JH, Binnie CD, Smit AM, Wilkins AJ: Selective cognitive impairment during focal and generalized epileptiform EEG activity. Brain 1984;107:293–308.
  52. De Toffol B: Syndromes épileptiques et troubles psychotiques. Montrouge, John Libbey Eurotext, 2001.
  53. Kwan P, Brodie MJ: Neuropsychological effects of epilepsy and antiepileptic drugs. Lancet 2001;357:216–222.
  54. Griffith HR, Martin RC, Bambara JK, Marson DC, Faught E: Older adults with epilepsy demonstrate cognitive impairments compared with patients with amnestic mild cognitive impairment. Epilepsy Behav 2006;8:161–168.
  55. Neary D, Snowden JS, Gustafson L, Passant U, Stuss D, Black S, Freedman M, Kertesz A, Robert PH, Albert M, et al: Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998;51:1546–1554.
  56. Sperfeld AD, Collatz MB, Baier H, Palmbach M, Storch A, Schwarz J, Tatsch K, Reske S, Joosse M, Heutink P, et al: FTDP-17: an early-onset phenotype with parkinsonism and epileptic seizures caused by a novel mutation. Ann Neurol 1999;46:708–715.
  57. Foster NL, Wilhelmsen K, Sima AA, Jones MZ, D’Amato CJ, Gilman S: Frontotemporal dementia and parkinsonism linked to chromosome 17: a consensus conference. Conference Participants. Ann Neurol 1997;41:706–715.
  58. Chong JY, Rowland LP, Utiger RD: Hashimoto encephalopathy: syndrome or myth? Arch Neurol 2003;60:164–171.
  59. Duffey P, Yee S, Reid IN, Bridges LR: Hashimoto’s encephalopathy: postmortem findings after fatal status epilepticus. Neurology 2003;61:1124–1126.
  60. McKeon A, McNamara B, Sweeney B: Hashimoto’s encephalopathy presenting with psychosis and generalized absence status. J Neurol 2004;251:1025–1027.
  61. Mocellin R, Lubman DI, Lloyd J, Tomlinson EB, Velakoulis D: Reversible dementia with psychosis: Hashimoto’s encephalopathy. Psychiatry Clin Neurosci 2006;60:761–763.
  62. Ferlazzo E, Raffaele M, Mazzu I, Pisani F: Recurrent status epilepticus as the main feature of Hashimoto’s encephalopathy. Epilepsy Behav 2006;8:328–330.
  63. Archambeaud F, Galinat S, Regouby Y, Magy L, Rebeyrotte I, Vallat JM, Teissier MP: Hashimoto encephalopathy. Analysis of four case reports. Rev Méd Interne 2001;22:653–659.
  64. Aronyk K, Petito F, Solomon GE: Partial elementary motor seizures as the first symptom of Creutzfeldt-Jakob disease. Ann Neurol 1984;15:210–211.
  65. Lee K, Haight E, Olejniczak P: Epilepsia partialis continua in Creutzfeldt-Jakob disease. Acta Neurol Scand 2000;102:398–402.
  66. Rees JH, Smith SJ, Kullmann DM, Hirsch NP, Howard RS: Creutzfeldt-Jakob disease presenting as complex partial status epilepticus: a report of two cases. J Neurol Neurosurg Psychiatry 1999;66:406–407.
  67. Parry J, Tuch P, Knezevic W, Fabian V: Creutzfeldt-Jakob syndrome presenting as epilepsia partialis continua. J Clin Neurosci 2001;8:266–268.
  68. Neufeld MY, Talianski-Aronov A, Soffer D, Korczyn AD: Generalized convulsive status epilepticus in Creutzfeldt-Jakob disease. Seizure 2003;12:403–405.
  69. Bowler JV: The concept of vascular cognitive impairment. J Neurol Sci 2002;203–204:11–15.
  70. Hauser WA, Kurland LT: The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 1975;16:1–66.
  71. Benbir G, Ince B, Bozluolcay M: The epidemiology of post-stroke epilepsy according to stroke subtypes. Acta Neurol Scand 2006;114:8–12.
  72. Reith J, Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS: Seizures in acute stroke: predictors and prognostic significance. The Copenhagen Stroke Study. Stroke 1997;28:1585–1589.
  73. Bladin CF, Alexandrov AV, Bellavance A, Bornstein N, Chambers B, Cote R, Lebrun L, Pirisi A, Norris JW: Seizures after stroke: a prospective multicenter study. Arch Neurol 2000;57:1617–1622.
  74. So EL, Annegers JF, Hauser WA, O’Brien PC, Whisnant JP: Population-based study of seizure disorders after cerebral infarction. Neurology 1996;46:350–355.
  75. Burn JDM: Epileptic seizures after a first stroke. Br Med J 1997;315:1582–1587.
  76. Lamy C, Domigo V, Semah F, Arquizan C, Trystram D, Coste J, Mas JL: Early and late seizures after cryptogenic ischemic stroke in young adults. Neurology 2003;60:400–404.
  77. De Reuck J, Goethals M, Vonck K, Van Maele G: Clinical predictors of late-onset seizures and epilepsy in patients with cerebrovascular disease. Eur Neurol 2005;54:68–72.
  78. Cordonnier C, Henon H, Derambure P, Pasquier F, Leys D: Influence of pre-existing dementia on the risk of post-stroke epileptic seizures. J Neurol Neurosurg Psychiatry 2005;76:1649–1653.
  79. Aldenkamp AP: Effects of antiepileptic drugs on cognition. Epilepsia 2001;42(suppl 1):46–49, discussion 50–41.
  80. Bergey GK: Initial treatment of epilepsy: special issues in treating the elderly. Neurology 2004;63:S40–S48.
  81. Pugh MJ, Cramer J, Knoefel J, Charbonneau A, Mandell A, Kazis L, Berlowitz D: Potentially inappropriate antiepileptic drugs for elderly patients with epilepsy. J Am Geriatr Soc 2004;52:417–422.
  82. Perucca E, Aldenkamp A, Tallis R, Kramer G: Role of valproate across the ages. Treatment of epilepsy in the elderly. Acta Neurol Scand 2006;184(suppl):28–37.
    External Resources
  83. Stephen LJ: Drug treatment of epilepsy in elderly people: focus on valproic acid. Drugs Aging 2003;20:141–152.
  84. Armon C, Shin C, Miller P, Carwile S, Brown E, Edinger JD, Paul RG: Reversible parkinsonism and cognitive impairment with chronic valproate use. Neurology 1996;47:626–635.
  85. Guerrini R, Belmonte A, Canapicchi R, Casalini C, Perucca E: Reversible pseudoatrophy of the brain and mental deterioration associated with valproate treatment. Epilepsia 1998;39:27–32.
  86. Masmoudi K, Gras-Champel V, Masson H, Andrejak M: Parkinsonism and/or cognitive impairment with valproic acid therapy: a report of ten cases. Pharmacopsychiatry 2006;39:9–12.
  87. Hommet C, Mondon K, de Toffol B, Constans T: Reversible cognitive and neurological symptoms during valproic acid therapy. J Am Geriatr Soc 2007;55:628.
  88. Arroyo S, Kramer G: Treating epilepsy in the elderly: safety considerations. Drug Saf 2001;24:991–1015.
  89. Brodie MJ, Overstall PW, Giorgi L: Multicentre, double-blind, randomised comparison between lamotrigine and carbamazepine in elderly patients with newly diagnosed epilepsy. The UK Lamotrigine Elderly Study Group. Epilepsy Res 1999;37:81–87.
  90. Pohlmann-Eden B: Issues when treating epilepsy in the elderly. Acta Neurol Scand 2005;181(suppl):40–46.
    External Resources
  91. Giorgi L, Gomez G, O’Neill F, Hammer AE, Risner M: The tolerability of lamotrigine in elderly patients with epilepsy. Drugs Aging 2001;18:621–630.
  92. Martin PJ, Millac PA: Impact of lamotrigine on patients with refractory epilepsy: the Leicester experience. Seizure 1994;3:209–213.
  93. Ferrendelli JA, French J, Leppik I, Morrell MJ, Herbeuval A, Han J, Magnus L: Use of levetiracetam in a population of patients aged 65 years and older: a subset analysis of the KEEPER trial. Epilepsy Behav 2003;4:702–709.
  94. Leppik IE, Birnbaum A: Epilepsy in the elderly. Semin Neurol 2002;22:309–320.
  95. Rowan AJ, Ramsay RE, Collins JF, Pryor FM, Boardman KD, Uthman BM, Spitz M, Frederick T, Towne A, Carter GS, et al: New onset geriatric epilepsy. A randomized study of gabapentin, lamotrigine, and carbamazepine. Neurology 2005;64:1868–1873.
  96. Sheorajpanday RV, De Deyn PP: Epileptic fits and epilepsy in the elderly: General reflections, specific issues and therapeutic implications. Clin Neurol Neurosurg 2007;109:727–743.
  97. Schneider LS, Tariot PN, Dagerman KS, Davis SM, Hsiao JK, Ismail MS, Lebowitz BD, Lyketsos CG, Ryan JM, Stroup TS, et al: Effectiveness of atypical antipsychotic drugs in patients with Alzheimer’s disease. N Engl J Med 2006;355:1525–1538.
  98. Ketter TA, Wang PW, Becker OV, Nowakowska C, Yang YS: The diverse roles of anticonvulsants in bipolar disorders. Ann Clin Psychiatry 2003;15:95–108.
  99. Levy RH, Collins C: Risk and predictability of drug interactions in the elderly. Int Rev Neurobiol 2007;81:235–251.