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Epilepsy and dementia

Dementia and epilepsy often occur together and it is important to be aware of the symptoms of seizures and how they can be diagnosed and managed.

As part of the Make March Purple initiative, we are spreading awareness about epilepsy and dementia.

Epilepsy most commonly occurs in the youngest and oldest age groups. People aged 75 years and older are most likely to develop late-onset epilepsy, but it can occur in middle age (from 50 years+).

While it has long been known that dementia increases the risk of and may cause epilepsy, recent studies have found that epilepsy itself may contribute to the development of dementia, especially in Alzheimer’s disease.


  • The prevalence of epilepsy in all people living with dementia is approximately 5%.
  • The prevalence of dementia in people living with epilepsy ranges from 8 – 17%.

Seizure risk for different types of dementia

  • People over 65 years with Alzheimer’s disease are up to ten times more likely to have seizures than those without dementia.
  • People living with familial, early-onset Alzheimer’s disease (under 65 years) a comparatively rare form of Alzheimer’s making up only 1% of all cases, are much more at risk of experiencing seizures (over 80 times more likely than people their age without Alzheimer’s).
  • People over 65 years with vascular dementia are up to ten times more likely to have seizures than those without dementia.
  • Approximately 2% of people with frontotemporal dementia have seizures.

Seizure symptoms

Most epileptic seizures in people with dementia are called “focal onset seizures” or “partial onset seizures”. Seizure symptoms can include:

  • An aura with visual and or auditory hallucinations
  • Brief periods of increased amnesia or unresponsiveness
  • Involuntary repeating movements or muscle twitching (hands and arms, or mouth such as chewing, lip-smacking or swallowing).

These symptoms can be fleeting and are often missed or confused with dementia symptoms.

Seizure management

If you think that you or someone you know with dementia may be having epileptic seizures, you should tell your GP or specialist. Take along a written history about what symptoms you’ve noticed and when they have occurred. Even better, take a video on your phone and show that to your doctor.

Further tests may be needed, including an EEG (Electroencephalogram) which records the electrical activity of the brain, an MRI or a CT scan. Based on the results of these tests, your doctor will make a diagnosis and develop an appropriate treatment plan. This may include medications that are effective at reducing and potentially stopping epileptic seizures.

Lifestyle management

It is important to understand that it can sometimes be difficult to differentiate between epilepsy seizure symptoms, dementia and some psychiatric disorders such as depression and anxiety.

Maintaining a healthy lifestyle including reducing stress, getting adequate sleep limiting alcohol, increasing physical activity and engaging in meaningful activities can help. Known precipitants for seizures such as strobe lighting should be avoided. It is also important to have regular checks with your GP and specialist to ensure medication management is optimal.