Management of epilepsy in Alzheimer’s disease in Down syndrome

Introduction Down syndrome (DS) is a genetically determined form of Alzheimer’s disease (AD) and specific epilepsy strongly associated with AD in DS (DSAD), late onset myoclonic (LOMEDs), but, there are no clinical trials evaluating the efficacy tolerability antiseizure medications this Aims To describe our experience treatment LOMEDs. Material Methods We recruited patients symptomatic (prodromal –pAD- or dementia –dAD- stages) context health plan for adult population between January 2013 November 2021. This included semiannual follow-ups (or as clinically needed) an anamnesis structured questionnaire including personal history (duration epilepsy, semiology, frequency, ASM). Results The study 72 pAD (48.6% females) 257 dAD (50.6% females). Bilateral tonic-clonic seizures (BTCS) were most frequent type (85.7% 70.7% dDS) frequentlly coexisted (16.7% 57.6% pDS respectively). after first seizure was levetiracetam (LEV) (61.5%) followed by valproate (VPA) (19.6%). During follow-up, 75.8% on monotherapy LEV (56.3%), VPA (25.5%) brivaracetam (BRV) (8.2%). discontinued due to irritability 21.9% (interestingly 48% tolerated BRV discontinuation).VPA abandoned 14% motor worsening. Seizure control at one year achieved 65.9%, when considering BTCS, but only 30.2% free seizures. Discussion LOMEDs very common comorbidity DSAD that responds partially treatment. BTCS seem have better response compared