Clinical Report: Epilepsy Study Maps Down Syndrome Course
Overview
A multicenter observational study reveals that epilepsy prevalence in adults with Down syndrome increases significantly with age, particularly following symptomatic Alzheimer's disease. The study analyzed data from 4,804 adults, highlighting a cumulative incidence of late-onset myoclonic epilepsy in Down syndrome (LOMEDS) and its association with cognitive decline and increased mortality risk.
Background
Individuals with Down syndrome have a heightened risk of developing Alzheimer's disease due to genetic factors. This study explores the relationship between Down syndrome, Alzheimer's disease, and the incidence of epilepsy.
Data Highlights
Age Group
Epilepsy Prevalence (per 1,000)
18-24 years
39
60 years or older
390
Asymptomatic Alzheimer's
121
Symptomatic Alzheimer's
459
Key Findings
Active epilepsy was identified in 15% of the 4,804 adults with Down syndrome studied.
Prevalence of epilepsy increased from 39 per 1,000 in ages 18-24 to 390 per 1,000 in those aged 60 and older.
Cumulative incidence of LOMEDS increased from 10% at Alzheimer's diagnosis to 57% at 9 years post-diagnosis.
Myoclonic and generalized tonic-clonic seizures were the most frequently observed seizure types.
Patients with symptomatic Alzheimer's disease without LOMEDS experienced a cognitive decline of 3.6 points per year, which accelerated to 7.8 points per year after seizure onset.
Clinical Implications
The findings suggest that clinicians should monitor adults with Down syndrome for the onset of epilepsy, especially as they age and if they develop Alzheimer's disease.
Conclusion
This study highlights the relationship between Down syndrome, Alzheimer's disease, and epilepsy.
Researchers compared full‐pressure and low‐pressure external counterpulsation during a 12‐month trial in patients with clinically diagnosed early Alzheimer disease.
