BACKGROUND: Although EEG is not considered as standard in memory clinics, evidence indicates that epileptiform discharges are of value in diagnosing cognitive complaints as epilepsy. OBJECTIVE: To determine prevalence and significance of epileptiform discharges in a memory clinic. METHODS: 1,674 consecutive patients underwent routine EEGs [mean age 66 years, diagnoses: Alzheimer disease (AD; n = 510), other dementia (n = 193), mild cognitive impairment (MCI; n = 225), subjective complaints (n = 368), and other disorders (n = 378)]. Database statistics, charts and EEG reports were reviewed. RESULTS: Epileptiform discharges were present in 42 (3%) patients, of which 60% lacked clinical seizures. All discharges were focal and predominantly temporally localized. Epileptiform activity was not associated with a dementia diagnosis (2% in AD and 1% in other dementia vs. 2% in MCI, 2% in subjective complaints and 5% in other disorders, p = 0.07) or with lower Mini-Mental State Examination scores (p = 0.69). Two (diagnoses: AD, vascular dementia) of 20 patients with epileptiform activity without clinical seizures developed first seizures after 2 years. CONCLUSION: In a memory clinic cohort, epileptiform discharges are rare, nonspecific and indicate a moderate risk of first-ever seizures in demented patients. These findings should be taken into account when routinely evaluating memory clinic patients with EEG.
BACKGROUND: Although EEG is not considered as standard in memory clinics, evidence indicates that epileptiform discharges are of value in diagnosing cognitive complaints as epilepsy. OBJECTIVE: To determine prevalence and significance of epileptiform discharges in a memory clinic. METHODS: 1,674 consecutive patients underwent routine EEGs [mean age 66 years, diagnoses: Alzheimer disease (AD; n = 510), other dementia (n = 193), mild cognitive impairment (MCI; n = 225), subjective complaints (n = 368), and other disorders (n = 378)]. Database statistics, charts and EEG reports were reviewed. RESULTS:Epileptiform discharges were present in 42 (3%) patients, of which 60% lacked clinical seizures. All discharges were focal and predominantly temporally localized. Epileptiform activity was not associated with a dementia diagnosis (2% in AD and 1% in other dementia vs. 2% in MCI, 2% in subjective complaints and 5% in other disorders, p = 0.07) or with lower Mini-Mental State Examination scores (p = 0.69). Two (diagnoses: AD, vascular dementia) of 20 patients with epileptiform activity without clinical seizures developed first seizures after 2 years. CONCLUSION: In a memory clinic cohort, epileptiform discharges are rare, nonspecific and indicate a moderate risk of first-ever seizures in demented patients. These findings should be taken into account when routinely evaluating memory clinic patients with EEG.
Authors: Keith A Vossel; Alexander J Beagle; Gil D Rabinovici; Huidy Shu; Suzee E Lee; Georges Naasan; Manu Hegde; Susannah B Cornes; Maya L Henry; Alexandra B Nelson; William W Seeley; Michael D Geschwind; Maria L Gorno-Tempini; Tina Shih; Heidi E Kirsch; Paul A Garcia; Bruce L Miller; Lennart Mucke Journal: JAMA Neurol Date: 2013-09-01 Impact factor: 18.302
Authors: Keith A Vossel; Kamalini G Ranasinghe; Alexander J Beagle; Danielle Mizuiri; Susanne M Honma; Anne F Dowling; Sonja M Darwish; Victoria Van Berlo; Deborah E Barnes; Mary Mantle; Anna M Karydas; Giovanni Coppola; Erik D Roberson; Bruce L Miller; Paul A Garcia; Heidi E Kirsch; Lennart Mucke; Srikantan S Nagarajan Journal: Ann Neurol Date: 2016-11-07 Impact factor: 10.422
Authors: Haakon B Nygaard; Adam C Kaufman; Tomoko Sekine-Konno; Linda L Huh; Hilary Going; Samantha J Feldman; Mikhail A Kostylev; Stephen M Strittmatter Journal: Alzheimers Res Ther Date: 2015-05-05 Impact factor: 6.982
Authors: David C Consoli; Lillian J Brady; Aaron B Bowman; Erin S Calipari; Fiona E Harrison Journal: J Neurochem Date: 2020-09-21 Impact factor: 5.372