Abstracts

Acetylcholinesterase (AChE) inhibitors are known to lower the seizure threshold in patients suffering from Alzheimer[apos]s disease and associated epileptic seizures, but little is known if seizures can be prevented in these patients if they maintain a therapeutic level of their antiepileptic drug (AED). In a retrospective study, patients were selected if they fulfilled the NINCDS-ADRDA Work Group criteria for Alzheimer[apos]s disease and if associated complex partial and secondarily generalized seizures were demonstrated clinically and by electroencephalogram (EEG) in the same patients who had simultaneous treatment with AChE inhibitors and AEDs which were maintained within therapeutic range. From June 12, 2000 to March 12, 2004, fourteen patients fulfilled the selection criteria. There were eleven female and three male patients. Age varied from 52 to 86 years. Five patients had complex partial and nine patients had secondarily generalized seizures. One patient with secondarily generalized seizures had underlying Down syndrome. Eight patients were taking phenytoin, four patients were taking carbamazepine and two patients were taking valproic acid. The AEDs were kept within therapeutic level. Thirteen patients were taking donepezil and one patient was taking rivastigmine. After the AChE inhibitors were withdrawn, all patients achieved control of their seizures. Despite maintaining an AED therapeutic level in patients with Alzheimer[apos]s disease and associated epileptic disorder, simultaneous treatment with AChE inhibitors (donepezil, rivastigmine and likely galantamine) threatens an optimal seizure control.