Evaluation of Comorbid Epilepsy and Dementia

Abstract

Epilepsy and dementia are both commonly occurring neurological disorders. In fact, these disorders fall in the top four most common neurological illnesses, along with migraine and stroke. Alzheimer's disease (AD) is estimated to occur in over five million people across the USA and epilepsy in just under three million individuals. Epilepsy is broadly defined as a disorder of the brain characterized by a persistent predisposition to epileptic seizures. More specifically, epilepsy is diagnosed when at least two unprovoked seizures occur more than 24 h apart. An unprovoked seizure is one that has no clear antecedent cause. An epilepsy diagnosis can be given following one unprovoked seizure if the probability of further seizures is similar to the general recurrence risk after two unprovoked seizures (at least 60%). In general, there is a high rate of medical and psychological comorbidity among individuals with epilepsy and dementia. It is important to obtain a comprehensive medical and psychiatric history and be aware of the effects of additional conditions on cognitive functioning. Common initial misdiagnoses include altered mental status, confusion, "blackout spells", memory disturbance, syncope, dizziness, dementia, transient ischemic attack, depression, metabolic disorders, and/or psychiatric disorders. (PsycInfo Database Record (c) 2021 APA, all rights reserved) (Source: chapter)