Abstracts

Rationale: Frontotemporal dementia (FTD) is a highly prevalent neurodegenerative disorder, with tauopathy, that can often co-occur with seizures. (1,2) FTD with epilepsy has a point prevalence of up to 6%. (3) Seizures are associated with faster cognitive decline in dementia. However, there is limited literature on characteristics of people with FTD and co-morbid seizures. This study aimed to assess the characteristics of the FTD with comorbid seizures (FTD+SZ), compared to FTD without seizures (FTD-SZ).


Methods: This is a retrospective, single-center study. All the patients clinically diagnosed with FTD, based on ICD-10 criteria, were included. They were divided into those with FTD with and without seizures. Data was collected from electronic medical records and included dementia related variables (age of dementia onset, family history of dementia, sex, hypertension, hyperlipidemia, diabetes, stroke, coronary artery disease or peripheral arterial disease, subtypes of FTD, use of dementia medications), epilepsy risk factors (head trauma, family history of epilepsy, CNS vascular disease) and mood (depression, anxiety). EEG data was additionally obtained for FTD+SZ. Pearson’s Chi squared test was utilized for the analysis of categorical data. T-test was used to analyze continuous data.


Results: Of the 65 FTD patients who met the inclusion criteria, fifteen (23.1%) had co-morbid seizures. Twenty-nine (44.6%) of the patients were female. The average age of dementia onset was 62.92 +10.04 years for the entire cohort (Table 1).

The average age of FTD+SZ was 62.53 years at the onset of dementia. Of these, ten (66.7%) patients had epilepsy, two (13.3%) had acute symptomatic seizures, two (13.3%) had one-time unprovoked seizure and one (6.7%) had myoclonus due to encephalopathy. FTD+SZ were more likely to be female (66.7% vs 38.0%, p=0.0519) and were significantly more likely to have head trauma (25.0 % vs 4.0%, p=0.0430). Although not statistically significant, semantic variant Primary Progressive Aphasia was more prevalent in FTD+SZ compared to FTD-SZ (Figure 1). EEG was done in 9 (60%) of FTD+SZ. One (11.1%) EEG showed temporal onset seizure, two (22.2%) reported epileptiform discharges (one generalized, one temporal), two (22.2%) had focal slowing in the temporal region but no definite epileptiform discharges, and two (22.2%) had non-specific encephalopathy (Figure 2).


Conclusions: Co-morbid seizures are more common in women with FTD and those with history of head trauma. Epilepsy is more commonly associated with non-behavioral variants of FTD. EEG is abnormal in >50% of those with FTD+SZ with most common non-epileptiform and epileptiform abnormalities observed in the temporal regions.


Funding: No funding was received for this study.