Epilepsien bei demenziellen und neurodegenerativen Erkrankungen

The association between neurodegenerative disorders with dementia and epilepsies has received little attention. However, this connection deserves a higher level of alertness if only due to the expected demographic developments which suggest an increasing prevalence of each disease group. The frequently used term,epilepsy of the eldery" falsely suggests a uniform pathogenesis and therapy, but is clearly insufficient to reflect the different pathopysiological and therapeutic considerations of different neurodegenerative syndromes leading to epilepsy in elderly patients. Especially the frequent association of recurrent seizures and Alzheimer's disease is a problem whose important medical and social implications are often neglected. Concerning epilepsies in other neurodegenerative diseases, there is insufficient and incoherent evidence about epidemiological, pathophysiological, semiological or therapeutic connections and considerations. Therefore it seems difficult to propose a syndromal classification of epilepsies in the heterogeneous group of neurodegenerative disorders with dementia. This review outlines the available data about epidemiological, (differential) diagnostic, semiological, pathophysiological and therapeutic aspects of epilepsies in neurodegenerative disorders with dementia.