LAUSR

In this month’s journal club we explore the significance of seizures in patients with dementia, events that can be distressing for both patients and relatives. Unprovoked seizures in Alzheimer’s disease are thought to affect up to a fifth of patients. However, seizures may be more difficult to identify so that rather than classical motor manifestations, patients may exhibit episodic confusion, behavioural change, increased drowsiness and/or clumsiness. The post-ictal state can also manifest as prolonged episodes of altered mental state which may further obscure or delay the diagnostic process leading to misdiagnoses with psychiatric disorders, metabolic disorders or transient ischaemic attacks. In addition, the effects of recurrent seizure activity on cognitive decline in these patients remain unclear. The first paper discussed looks at a novel way to investigate patients with Alzheimer’s disease and suspected seizure activity. In the second paper, Vossel et al. explore the impact of subclinical epileptiform activity and its effects on cognition. Finally, the third paper discussed investigates the pathological mechanism of cognitive impairment in temporal lobe epilepsy specifically considering whether the presence of a tauopathy in temporal lobe resections links epilepsy to the pathology underlying Alzheimer’s disease and chronic traumatic encephalopathy.