Mapping epilepsy in Down syndrome
Seven international cohorts examined epilepsy incidence, cognitive trajectories, and survival in adults with Down syndrome.
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By
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Kathryn Wighton
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September 21, 2026
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Clinical Scorecard: Epilepsy study maps Down syndrome course
At a Glance
| Category | Detail |
|---|
| Condition | Down syndrome and epilepsy |
| Key Mechanisms | Age-related increases in epilepsy prevalence driven by symptomatic Alzheimer's disease |
| Target Population | Adults with Down syndrome |
| Care Setting | Specialist clinics |
Key Highlights
- 15% of adults with Down syndrome had active epilepsy at the last visit.
- Epilepsy prevalence increased from 39 per 1,000 patients aged 18 to 24 years to 390 per 1,000 among those aged 60 years or older.
- Cumulative incidence of late-onset myoclonic epilepsy in Down syndrome increased from 10% at Alzheimer's diagnosis to 57% at 9 years post-diagnosis.
- Seizure onset was associated with a steeper decline in cognitive function.
- Myoclonic and generalized tonic-clonic seizures were the most frequently observed seizure types.
Guideline-Based Recommendations
Diagnosis
- Active epilepsy requires an epilepsy diagnosis plus ongoing antiseizure drug use or at least 1 unprovoked seizure during the previous 5 years.
Management
- Monitor cognitive status and seizure types in adults with Down syndrome.
Monitoring & Follow-up
- Longitudinal assessments of cognitive function and seizure activity are recommended.
Risks
- LOMEDS is associated with about twice the mortality risk.
Patient & Prescribing Data
Adults with Down syndrome, particularly those with Alzheimer's disease.
Electroencephalographic measures showed limited diagnostic performance for epilepsy.
Clinical Best Practices
- Consider the cognitive trajectory in patients with Down syndrome and epilepsy.
- Account for the potential impact of Alzheimer's disease on seizure incidence and cognitive decline.
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