Seizures occur when abnormal electrical signals disrupt normal communication in the brain. If someone experiences multiple seizures without an identifiable cause (such as a head or brain injury), health care providers may diagnose epilepsy.

Alzheimer’s disease and epilepsy are common neurological disorders (diseases of the nervous system). The likelihood of both conditions increases with age, and seizures can occur during either the early or late stages of Alzheimer’s disease.

Many myALZteam members have described seizures in themselves or their loved ones. “Mom had a rough day yesterday. She woke up to a 45-minute seizure and spent the day alternating between weeping and being ‘flat,’” one member wrote.

Research has uncovered several ways these two conditions may be related. Here’s what you should know.

How Common Are Different Types of Seizures?

People over 65 with Alzheimer’s disease are up to 10 times more likely to develop epilepsy compared to those without Alzheimer’s. Research shows that around 17 percent of people with Alzheimer’s develop new-onset seizures after diagnosis. Of those with new-onset seizures, around 11 percent experience generalized tonic-clonic seizures (GTCS), also known as grand mal seizures. These seizures typically last a few minutes, involve uncontrollable muscle movements, and can sometimes result in injuries. However, GTCS are not the most common seizure type seen in people with Alzheimer’s disease.

Focal seizures, which affect only one part of the brain, are far more frequent, accounting for 55 percent to 70 percent of seizures in people with Alzheimer’s. Focal seizures, also referred to as partial seizures, can cause sensory changes, such as hearing, vision, or smell disturbances.

A significant proportion of these focal seizures, up to 72 percent, are focal seizures with impaired awareness. A person experiencing this type appears awake but is unresponsive to their surroundings. These seizures can cause unusual behaviors like running, crying, laughing, or smacking lips. After the seizure, individuals often experience confusion or drowsiness, known as the postictal period.

Myoclonic seizures, which involve sudden jerking movements, are another seizure type that may occur in people with Alzheimer’s. These often happen in clusters, meaning several seizures can occur in a day or over consecutive days.

Seizures affecting the temporal lobe, a part of the brain responsible for memory and emotions, are also common. Temporal lobe seizures often cause a temporary loss of awareness, even though the person may appear awake. These seizures can lead to unusual behaviors and may be followed by a period of sleepiness or confusion during the postictal phase.

Theories Behind the Link

Researchers are still trying to figure out if Alzheimer’s causes seizures or if seizures contribute to the development of Alzheimer’s. Some believe these two conditions share similar features that make them worsen together. Both involve changes in brain chemicals, including inflammation and impaired blood flow in the brain.

One theory suggests that the extra brain activity from seizures might lead to the buildup of amyloid plaques and tau tangles, two common features of Alzheimer’s disease. However, researchers also propose that amyloid plaques already in the brain could lead to an increased risk for seizures.

Additionally, antiseizure medications (also known as antiepileptic drugs) may worsen cognitive symptoms, such as memory loss and thinking difficulties. Certain antipsychotic medications prescribed to people with Alzheimer’s may also elevate the risk of seizures. These include clozapine (Clozaril, Versacloz) and quetiapine (Seroquel).

While more research is needed, it is becoming clear that Alzheimer’s and epilepsy can influence each other in multiple ways. Studies have shown that people with Alzheimer’s who experience seizures may face more rapid cognitive decline. Finding safe and effective treatment options to manage both conditions is crucial.

Managing Seizures in Alzheimer's Disease

Witnessing a loved one have a seizure can be a traumatic experience, and for those experiencing seizures themselves, it can feel frightening and unpredictable. Members of myALZteam have shared their experiences of watching their loved ones navigate seizures alongside Alzheimer’s.

“My husband had many seizures before he was put on antiseizure meds. He continued to have them even then until they got his meds stabilized. He’s now in a nursing home and still has seizures occasionally. It’s really hard to watch,” explained one member.

“My wife would have seizures. Her head would go down and, after a while, come back up. They were never very long. She would not remember them and just continue as if they never happened,” shared another.

Another responded, “My wife’s seizures, which were more violent and prolonged than what you have described, were ‘cured’ when she was prescribed levetiracetam (Keppra).”

Adding epilepsy to an Alzheimer’s diagnosis can bring new challenges that significantly affect daily life. Up to 22 percent of people with Alzheimer’s will have an unexpected seizure eventually, so it’s important for family members and caregivers to recognize the signs and be prepared.

If someone is having a seizure, the most important thing to do is keep them safe until it passes. Here are some additional critical points to remember:

• Never hold them down or put anything in their mouth (including water or medication).
• Remove any sharp objects nearby, and try to prevent them from falling.
• If they’re already lying down, turn them onto their side to help them breathe better.
• If possible, start a timer to measure how long the seizure lasts.

As the connection between seizures and Alzheimer’s disease becomes better understood, it’s never too early to ask a health care provider about what to watch for and how to respond if your loved one has a seizure.

Seizure Treatment Options

Health experts are still figuring out the best way to treat seizures in people with Alzheimer’s disease. Currently, in many cases, doctors may recommend the medications levetiracetam (sold under the brand names Elepsia, Keppra, and Roweepra) and lamotrigine (Lamictal and Subvenite). These medications can help prevent seizures and may offer other benefits, like boosting brain function and reducing depression.

However, there are many factors to consider when prescribing treatments for people with Alzheimer’s disease. Since most people with Alzheimer’s are older and many are already on several medications, special care is required to avoid dangerous interactions and side effects. Doctors must consider the person’s heart, liver, and kidney function before selecting the right medications. Living a healthy lifestyle and getting enough sleep can also reduce seizure risk.

One myALZteam member explained that antiseizure medications ended up not being a good fit for their mother. “We took Mom to the neurologist. She had a seizure episode when he was testing her strength. We started her on a low dose of lamotrigine, which made her nauseous for most of the day. She vomited all over the bed during the night and said she felt really sick,” they wrote. “After conferring with the family and her primary care physician, it was decided to discontinue the seizure meds and proceed with full hospice care at home.”

Caring for someone with Alzheimer’s means carefully weighing the pros and cons of different treatments. It’s important to balance the potential benefits with possible side effects. Fortunately, you don’t have to make these decisions alone. Discussing options with a neurology team and hearing from others in similar situations can help you feel confident in making the best choices.

Talk With Others Who Understand

On myALZteam, the social network for people with Alzheimer’s disease and their family members, more than 86,000 people ask questions, give advice, and share stories with others who understand life with Alzheimer’s disease.

Did you know that Alzheimer’s might be a risk factor for seizures? How have seizures affected your loved one’s cognitive function and daily life? Share your experience in the comments below, or start a conversation by posting on your Activities page.