Differential diagnosis of epilepsy and dementia in the elderly:A new treatable dementia

Masumi Ito

Jozen Clinic

The symptoms of epilepsy in the elderly are difficult to diagnose, and often misidentified as dementia.　In case of intermittent seizures with loss of consciousness, the patient may complain of subjective forgetfulness.　In the case of transient epileptic amnesia （TEA）, the patient has repeated amnesia with fully consciousness.　In TEA, cross-sectional cognitive function is normal, but exhibits a few specific type of forgetting.　In contrast, there is a group of patients with progressive and persistent cognitive decline, accompanied by ADL decline and psychiatric symptoms.　In order to diagnose epilepsy in the elderly, it is important to keep epilepsy in mind and interview the patient’s symptoms in detail.　An electroencephalogram （EEG） is useful in confirming the diagnosis.　Since epilepsy in the elderly is highly responsive to antiepileptic drugs and has a good prognosis, epilepsy should be widely recognized as a treatable dementia.

Address correspondence to Dr. Masumi Ito, Jozen Clinic（Higashi 2-2-6, Kita 3, Chuo-ku, Sapporo 060-0033, Japan）