Dementia and seizures may be caused by the same condition(s):
(1) Alzheimer's disease, especially in the later stages or with early onset familial forms
(2) head trauma
(3) metabolic disorders
(4) Creutzfeldt-Jakob disease
(5) vascular or small blood vessel disease
Worsening of the underlying disease can cause both conditions to get worse.
Seizures may be difficult to identify in a demented patient, especially if a movement disorder is present.
Complications of seizures:
(1) fall injury
(2) fractures, especially if osteoporosis is present
(3) false claims of elder abuse
(4) temporary worsening of cognitive function in the post-ictal period (confusion, delirium, etc)
(5) worsening of incontinence
Seizure medication may worsen the cognitive impairment or have unwanted side effects. It is important to:
(1) use an antiepileptic agent with minimal cognitive adverse effects
(2) use the lowest possible dose that is effective
(3) consider therapeutic drug monitoring to ensure therapeutic levels and avoid drug accumulation
Frequent seizures may increase caregiver burden and may result in the patient being institutionalized.
