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P2‐291: THE DIAGNOSTIC CHALLENGE OF NEUROPSYCHIATRIC SYMPTOMS IN ALZHEIMER'S DISEASE: A CASE REPORT
Author(s) -
Eikelboom Willem S.,
Berg Esther,
Coesmans Michiel,
Jiskoot Lize C.,
Swieten John C.,
Ossenkoppele Rik,
Seelaar Harro,
Papma Janne M.
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.980
Subject(s) - memory clinic , apathy , psychiatry , medicine , personality changes , dementia , psychology , neurological examination , outpatient clinic , pediatrics , disease , cognition
primarily involving the posterior cortex. Numerous studies describe the neuropsychological, clinical and classic neuroimaging findings for PCA, however little is known about the electroencephalogram (EEG) findings of patients with PCA. Methods: A retrospective chart review was performed on a total of 139 patients identified either from theMayo Clinic Brain Bank with neuropathologic diagnosis of PCA or clinically as PCA. Clinical data obtained included demographics, EEG descriptions, and antiepileptic drug (AEDs) usage by reviewing records from January 1990 through December 2017.Results:Of the 139 patients reviewed, 23 patients (16.5%) underwent short-term or long-term EEG recording. The mean age at time of EEG was 64 years and mean age of subjective symptom onset was 59 years. The mean time from subjective symptom onset to time of EEGwas 5 years. Seventeen patients (74%) of the 23 had an abnormal EEG characterized by slowing (focal or generalized) and/or epileptic discharges (EDs). Of these, 13 (74%) had varying degree of generalized slowing while 4 (26%) had focal slowing involving the temporal lobe. EDs were found in two patients (12%), both with generalized and independent temporal lobe discharges. Neither had history of seizures, however, AEDs were initiated given the EEG findings. Three patients had benign EEG variants. Conclusions: The present study suggests that EEG is performed only in a minority of patients with PCA. Generalized and/or focal slowing of background activity was most prevalent, akin to previous studies in patients with AD (De Waal 2011). The presence of EDs, without known pre-existing seizure disorder, together with an increased propensity for abnormal electrographic slowing in this cohort reaffirms the necessity of EEG during the diagnostic evaluation of PCA, as treatment with AEDs may improve the clinical state. Large prospective studies are needed to further establish the clinical utility of EEG in PCA.