Epilepsy research · 2025
Co-morbid seizures in frontotemporal dementia: What do they tell us?
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Hashmi Syeda Amrah, Quigg Mark, D'Abreu Anelyssa, Manning Carol, Kapur Jaideep, Zawar Ifrah
Аннотация
OBJECTIVES: Comorbid seizures occur in 2-11 % of frontotemporal dementia(FTD). Despite the high risk for seizures, the risk factors, clinical characteristics, and seizure outcomes in FTD patients with comorbid seizures remain understudied.
METHODS: All patients who presented to our hospital from 5/1/2011-4/30/2024 with a clinical diagnosis of FTD were included and subclassified into behavioral-variant FTD(bvFTD), sematic-variant-primary-progressive-aphasia(svPPA), or non-fluent-primary-progressive-aphasia(nfPPA). Demographics, comorbidities, dementia characteristics, and seizure characteristics were obtained from electronic medical records. Patients were classified into those with(FTD+SZ) or without(FTD-SZ) clinically-diagnosed seizures. Seizure outcome was categorized as uncontrolled, controlled on anti-seizure-medications(ASMs), or self-resolving if resolved without ASMs. Data were analyzed using Pearson's Chi-squared, Fisher Exact, or t-tests.
RESULTS: Of 317 FTD patients(average age of dementia onset=64.18+9.07years,46.37 % female]), 24(7.6 %) reported seizures. FTD+SZ were more likely to have anxiety(FTD+SZ=7(29.17 %),FTD-SZ= 35(11.95 %),p = 0.0392).Traumatic brain injury(TBI) was the only risk factor for seizures(FTD+SZ=6(25 %),FTD-SZ= 18(6 %),p < 0.001). BvFTD was the most common subtype in FTD+SZ(54.17 %). Focal seizures were more common(50 %) than generalized (29.17 %), with temporal-lobe epilepsy(TLE) being the most common subtype of focal seizures(42 %). Levetiracetam was the most frequently used ASM(38.1 %). Seizures had a favorable prognosis, with 87.5 % achieving seizure control through ASMs, and seizures self-resolving in the rest. FTD+SZ were more likely to be older at death(FTD+SZ=78.63years,FTD-SZ=71.37,p = 0.03966).
SIGNIFICANCE: The prevalence of comorbid seizures in FTD at our single-center is 7.6 %. They were most common in bvFTD, primarily focal, with TLE as the predominant subtype. Anxiety was more prevalent with comorbid seizures. Most achieved seizure control on ASMs. FTD+SZ were older at death. These findings address a critical gap, guiding diagnosis, management, and future research.
METHODS: All patients who presented to our hospital from 5/1/2011-4/30/2024 with a clinical diagnosis of FTD were included and subclassified into behavioral-variant FTD(bvFTD), sematic-variant-primary-progressive-aphasia(svPPA), or non-fluent-primary-progressive-aphasia(nfPPA). Demographics, comorbidities, dementia characteristics, and seizure characteristics were obtained from electronic medical records. Patients were classified into those with(FTD+SZ) or without(FTD-SZ) clinically-diagnosed seizures. Seizure outcome was categorized as uncontrolled, controlled on anti-seizure-medications(ASMs), or self-resolving if resolved without ASMs. Data were analyzed using Pearson's Chi-squared, Fisher Exact, or t-tests.
RESULTS: Of 317 FTD patients(average age of dementia onset=64.18+9.07years,46.37 % female]), 24(7.6 %) reported seizures. FTD+SZ were more likely to have anxiety(FTD+SZ=7(29.17 %),FTD-SZ= 35(11.95 %),p = 0.0392).Traumatic brain injury(TBI) was the only risk factor for seizures(FTD+SZ=6(25 %),FTD-SZ= 18(6 %),p < 0.001). BvFTD was the most common subtype in FTD+SZ(54.17 %). Focal seizures were more common(50 %) than generalized (29.17 %), with temporal-lobe epilepsy(TLE) being the most common subtype of focal seizures(42 %). Levetiracetam was the most frequently used ASM(38.1 %). Seizures had a favorable prognosis, with 87.5 % achieving seizure control through ASMs, and seizures self-resolving in the rest. FTD+SZ were more likely to be older at death(FTD+SZ=78.63years,FTD-SZ=71.37,p = 0.03966).
SIGNIFICANCE: The prevalence of comorbid seizures in FTD at our single-center is 7.6 %. They were most common in bvFTD, primarily focal, with TLE as the predominant subtype. Anxiety was more prevalent with comorbid seizures. Most achieved seizure control on ASMs. FTD+SZ were older at death. These findings address a critical gap, guiding diagnosis, management, and future research.