Research Week Abstract Book - Northern Health

Aged Care
LOOKING FOR SEIZures IN DemenTIA
Lim S & Pearson K.
Background
Seizures are known to be more common in patients with dementia compared with the general elderly population, however
little clarity exists regarding its epidemiology, diagnosis and management.
Aim
This paper evaluates the presentation of both tonic-clonic seizures as well as non-convulsive occipital epileptiform activity
in an elderly gentlemen with advanced Alzheimer’s disease complicated by behavioural and psychological symptoms of
dementia (BPSD). The role of electroencephalography (EEG) in diagnosing non-convulsive seizures amongst demented
individuals who are otherwise unable to describe symptoms of altered perceptions or fluctuating consciousness is discussed.
Methodology
A comprehensive systematic review of the literature was performed using the search terms ‘epilepsy’, ‘occipital seizures’,
‘dementia’ and ‘anti-epileptic medication’ in Ovid Medline and PubMed. References from each article were searched for
further studies of interest.
Results
Eighty-five publications were shortlisted for review in the following domains:
1. Seizures in the elderly with dementia
2. EEG in seizure evaluation
3. Treatment of epilepsy in elderly patients with dementia
Occipital seizures were diagnosed in the context of an abnormal EEG with behaviour suggestive of visual hallucinations in
the elderly patient described. The subsequent commencement of anti-epileptic medications led to improved compliance with
care and reduced BPSD.
Conclusion
Increased awareness regarding diagnosis and treatment of non-convulsive seizures in elderly patients with dementia can
lead to better care through reducing anti-psychotic use for agitation otherwise attributed to BPSD. The EEG can be a useful
tool in diagnosing focal epileptiform activity in the absence of clinical signs of seizures.
12 Research Week Abstract Book Northern Health 2013