Summary: A newly published study has uncovered a surprising and underappreciated link between frontotemporal dementia (FTD) and epileptic seizures, showing that individuals with FTD experience seizures far more frequently than once believed. This discovery challenges long standing assumptions and opens new avenues for early detection and treatment.
In some cases, epileptic episodes occurred up to ten years before the formal diagnosis of FTD, suggesting that seizures may serve as an early, underappreciated symptom of the disease.
Researchers examined over 12,000 medical records and found that epilepsy was notably more common in FTD patients compared to those with Alzheimer’s disease or healthy individuals. These findings suggest that routine screening for epilepsy in at-risk populations could lead to earlier detection, more targeted treatment, and improved quality of life for those affected by FTD
Key Facts:
- Hidden beginning mark: Attacks may last up to ten years before a diagnosis of FTD is made.
- High risk: Epilepsy was significantly more common in patients with FTD than in patients with Alzheimer’s disease.
- Treatment options: Detecting attacks can improve functioning and quality of life in FTD patients.
Source: University of Eastern Finland
A recent large-scale study has revealed that epileptic seizures are significantly more common in patients with frontotemporal dementia (FTD) than previously recognized. In some cases, seizures occurred up to ten years before an FTD diagnosis, suggesting they may serve as an early, overlooked symptom.
Researchers examined more than 12,000 medical records and discovered that epilepsy is significantly more prevalent in patients with frontotemporal dementia (FTD) than in those with Alzheimer’s disease or healthy individuals. This challenges previous assumptions and points to seizures as a potentially underrecognized symptom of FTD.
The findings underscore the need for early screening and intervention, as identifying epilepsy in at-risk individuals could lead to timelier diagnoses, more effective treatment plans, and ultimately, an improved quality of life for patients navigating the complexities of FTD.
This discovery deepens our understanding of the symptoms of this memory disorder and underscores the importance of considering epileptic seizures when treating and monitoring patients.
In this large-scale project by the University of Eastern Finland and the University of Oulu, in collaboration with Neurocentre Finland, the prevalence of epilepsy in FTD patients was investigated.
The research dataset is one of the largest in the world and the results have been published in the leading journal JAMA Neurology.
Early Epileptic Seizures as a Warning Sign for Frontotemporal Dementia
For example, while epilepsy is known to be associated with Alzheimer’s disease, research on its connection to frontotemporal dementia (FTD) has been limited. A newly published study helps fill this gap, revealing that epilepsy is significantly more common in patients with FTD than previously recognized.
The study analyzed medical records from the University Hospitals of Kuopio and Oulu between 2010 and 2021, examining over 12,000 cases. It found that epileptic seizures often occurred years before an FTD diagnosis, suggesting epilepsy may serve as an early warning sign for the disease.
From a total of 12,490 medical records, the study identified 245 patients with FTD and 1,326 with Alzheimer’s disease. In addition to examining the prevalence of epilepsy in these patients, this was also investigated in healthy controls.
“Our results show that epilepsy is significantly more common in people with FTD than in people with Alzheimer’s disease or healthy controls,” explains PhD candidate Annemari Kilpeläinen, the study’s lead author and a practicing neurologist.
Her findings underscore the importance of recognizing seizures as a potential early symptom of frontotemporal dementia—one that could open the door to earlier diagnosis and more effective treatment strategies.
Her findings highlight the need for improved screening and earlier intervention, as seizures may precede FTD diagnosis by several years—offering a potential window for timely treatment and better patient outcomes.
“It was also more common across all stages of the disease than previously reported in international studies.”
This finding suggests that epilepsy may not only be an early warning sign of frontotemporal dementia but also a persistent feature throughout its progression underscoring the need for continuous monitoring and tailored treatment strategies.
To explore this further, the study examined epilepsy prevalence at multiple time points—ranging from a decade before the FTD diagnosis to five years after revealing a consistent and elevated occurrence throughout the disease course.
In patients with FTD, the prevalence of epilepsy increased over time, and five years after diagnosis, approximately 11% of patients had epilepsy. In addition to the epilepsy diagnosis, FTD patients were also more likely to use anti-epileptic medication, which increases the reliability of the results.
Epilepsy cannot be diagnosed.
Diagnosing epilepsy in individuals with frontotemporal dementia (FTD) is particularly complex because the behavioral and cognitive changes typical of FTD such as sudden confusion, emotional outbursts, or lapses in awareness can closely mimic seizure symptoms.
As a result, epilepsy may go undetected or be misattributed to dementia progression, delaying effective treatment. Yet timely intervention is crucial, as untreated seizures can worsen neurological decline and further impair quality of life in FTD patients. Accurate diagnosis requires careful neurological assessment and often advanced imaging or EEG monitoring to separate seizure activity from dementia-related behaviors.
Yet, when epilepsy goes untreated in these patients, it can exacerbate neurological decline, intensify cognitive impairment, and reduce overall quality of life. Early and accurate detection is therefore essential to managing both conditions effectively.
“Detecting epilepsy is important because its treatment can improve patients’ functional abilities and overall quality of life,” explains the research team. Timely intervention may help slow cognitive decline and ease behavioral symptoms in those with frontotemporal dementia (FTD). Researchers are now asking whether epilepsy and FTD might share underlying pathophysiological mechanisms and whether some symptoms of FTD could stem from disruptions in the brain’s electrical activity rather than neurodegeneration alone.
explains Eino Solje, the project’s principal investigator and associate professor and director of the UEF Brain Research Unit.
A large research project brings together various scientific disciplines.
The recently published research is part of a larger project that combines exceptionally extensive data from real-life patients with several types of unique registries.
The project is based on close collaboration between the University of Oulu and the University of Eastern Finland, and researchers from various scientific disciplines, including medicine and law. The University Hospitals of Kuopio and Oulu are part of the European Reference EpiCARE and are recognized centers for epilepsy treatment and research.
Abstract
A recent large-scale study has shed light on the prevalence and timing of epilepsy in frontotemporal dementia (FTD), revealing a much stronger link than previously recognized.
Importance
Previous studies have hinted at a potential link between epilepsy and frontotemporal dementia (FTD), but until recently, this connection lacked comprehensive, systematic evidence. Most earlier research relied on isolated case reports or small sample sizes, leaving the true prevalence and timing of epilepsy in FTD largely unclear.
A newly published large-scale study has now filled this gap by analyzing over 12,000 medical records from Finnish university hospitals.
Objective
To determine whether epilepsy is more common in patients with FTD than in healthy controls (HCs) or patients with Alzheimer’s disease (AD).
Design, framework and participants
In this case-control study, we compared the prevalence of epilepsy and the use of anticonvulsant medications (ACDs) in patients with FTD, matched caregivers, and Alzheimer’s disease at two early-stage dementia assessment centers in the same geographical regions of Finland. Diagnoses of AD or FTD were made between January 1, 2010, and December 31, 2021.
Key findings and actions
The primary objective was to describe the prevalence of epilepsy in patients with FTD over a period of 10 years before diagnosis and 5 years afterward. We used codes from the International Statistical Classification of Diseases (ICSD), 10th revision, to identify all patients with epilepsy and track ASM acquisition.
Conclusion and relevance
This case-control study revealed that patients with frontotemporal dementia (FTD) had a significantly higher prevalence of epilepsy and greater use of antiseizure medications (ASMs) compared to those with Alzheimer’s disease (AD) and healthy controls (TS). These findings point to a possible connection between epileptic abnormalities and the underlying pathophysiology of FTD.
The results raise important questions about whether epilepsy and FTD may share overlapping mechanisms at the neurological level. Further research is essential to explore this potential link, which could pave the way for more targeted diagnostic tools and therapeutic strategies for both conditions
