Alzheimer's Disease (AD) and epilepsy are common neurological diseases. The prevalence of epilepsy in AD patients is higher than in healthy subjects, but identifying the reasons for this association, the characteristics of seizures in AD, and the implications for prognosis and treatment is challenging. The present review provides first of all an overview of the main clinical aspects of AD and epilepsy, of their reciprocal relationship, and of the challenges that identifying seizures in AD patients presents. Limitations of clinical studies addressing this topic are discussed, including their mostly prospective nature and possible selection biases. A comprehensive, mechanistic discussion on the factors that are most likely to underlie the increased risk for seizures in AD follows. These include, for instance, GABAergic and glutamatergic alterations, Aβ and Tau protein, the role of the noradrenergic nucleus Locus Coeruleus, and neuroinflammation. Finally, evidence concerning the role that epilepsy may have in exacerbating or initiating AD is reviewed. A mechanistic insight on the relationship between epilepsy and AD might have relevant implications for improving the treatment of AD patients, as well as in elucidating pathophysiological mechanisms.

中文翻译：

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癫痫和阿尔茨海默病：关联的潜在机制。

阿尔茨海默病 (AD) 和癫痫是常见的神经系统疾病。AD 患者癫痫的患病率高于健康受试者，但确定这种关联的原因、AD 癫痫发作的特征以及对预后和治疗的影响具有挑战性。本综述首先概述了 AD 和癫痫的主要临床方面、它们的相互关系以及识别 AD 患者癫痫发作的挑战。讨论了针对该主题的临床研究的局限性，包括它们主要是前瞻性的性质和可能的选择偏倚。下面对最有可能导致 AD 癫痫发作风险增加的因素进行全面的机械讨论。这些包括，例如，GABA 能和谷氨酸能改变、Aβ 和 Tau 蛋白、去甲肾上腺素能核蓝斑的作用和神经炎症。最后，回顾了关于癫痫可能在加重或引发 AD 中的作用的证据。对癫痫和 AD 之间关系的机制洞察可能对改善 AD 患者的治疗以及阐明病理生理机制具有相关意义。