てんかんと認知症

Epilepsy and Dementia

Point

・認知症患者にてんかんが合併する頻度は約5%である．

・認知症と併存するてんかんには，側頭葉てんかんが多く，焦点意識減損発作が多い．

・高齢初発のてんかんは，薬物治療での発作寛解率が高い．

　Older adults have a higher prevalence of both dementia and epilepsy. Epilepsy and dementia have a bidirectional relationship. Epidemiological studies have shown that elderly patients with epilepsy have approximately twice the risk of developing dementia compared to controls. Conversely, patients with dementia have twice the risk of developing epilepsy compared to controls. Seizure types in older adults with newly diagnosed epilepsy include focal-onset generalized tonic-clonic seizures and focal impaired awareness seizures without convulsions. The differential diagnosis between epilepsy and dementia can be challenging. Temporal lobe epilepsy may be overlooked in patients visiting dementia clinics. In some cases, temporal lobe epilepsy with frequent seizures may be misdiagnosed as dementia. Additionally, temporal lobe epilepsy in patients already diagnosed with dementia may go unrecognized. Diagnostic difficulties may also arise due to a lack of medical history or absence of eyewitness accounts. In older adults with newly diagnosed epilepsy, antiseizure medications are highly effective in controlling seizures. Accurate diagnosis is essential for effective seizure management and an improved quality of life.