![]() ![]() Caregivers might report that the patient seems to “check out” for periods of time or appears more confused than usual on some days than on others. The transient worsening of cognitive symptoms is frequent in patients with Alzheimer’s disease, sometimes raising the possibility of underlying epilepsy. Clinical trials targeting network hyperexcitability in patients with Alzheimer’s disease will identify whether AEDs or related strategies could improve their cognitive symptoms or slow decline. These AEDs target mechanisms of epileptogenesis involving amyloid β and tau. Moreover, studies in mouse models of Alzheimer’s disease suggest that certain classes of AEDs that reduce network hyperexcitability have disease-modifying properties. Treatment of clinical seizures in patients with Alzheimer’s disease with select antiepileptic drugs (AEDs), in low doses, is usually well tolerated and efficacious. Some evidence indicates that subclinical epileptiform activity in patients with Alzheimer’s disease, detected by extended neurophysiological monitoring, can also lead to accelerated cognitive decline. In patients with Alzheimer’s disease, seizures can hasten cognitive decline, highlighting the clinical relevance of early recognition and treatment. In clinical practice, seizures in patients with Alzheimer’s disease can easily go unrecognised because they usually present as non-motor seizures, and can overlap with other symptoms of the disease. Epileptic activity is frequently associated with Alzheimer’s disease this association has therapeutic implications, because epileptic activity can occur at early disease stages and might contribute to pathogenesis.
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