The literature on epileptic seizures in Alzheimer's disease has significantly increased over the past decades. Remarkably, several studies suggest a bi-directional link between these two common neurological diseases, with either condition carrying a nearly 2-fold risk of contracting the other in comparison to healthy subjects. In this respect, evidence from both clinical and preclinical studies indicates that epileptogenesis and neurodegeneration possibly share common underlying mechanisms. However, the precise association between epileptogenesis and neurodegeneration still needs to be fully elucidated. Targeted intervention to reduce abnormal network hyperexcitability might constitute a therapeutic strategy to postpone the onset of later neurodegenerative changes and consequent cognitive decline by many years in patients. By virtue of this, an early diagnosis and treatment of seizures in patients with Alzheimer's disease should be pursued. To date, no guidelines are available for treating epileptic activity in this context, largely due to the paucity of studies sufficient to answer the related questions. Accordingly, clinical trials are mandatory, not only to inform clinicians about symptomatic management of seizures in Alzheimer's disease patients but also to detect if treatment with antiseizure medications could have disease-modifying effects. Moreover, it will be fundamental to expand the application of animal models of Alzheimer's disease to comorbid conditions, such as epilepsy both to reveal the mechanisms underlying seizure onset and to better define their role in cognitive decline. Such models could also be useful to identify pharmacological compounds having therapeutically effectiveness as well as reliable early biomarkers for seizures in Alzheimer's disease.

中文翻译：

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癫痫和阿尔茨海默氏病：两种密切相关的病理学的当前概念和治疗观点。

在过去的几十年里，关于阿尔茨海默病癫痫发作的文献显着增加。值得注意的是，几项研究表明这两种常见的神经系统疾病之间存在双向联系，与健康受试者相比，这两种疾病中的任何一种都具有近 2 倍感染另一种疾病的风险。在这方面，来自临床和临床前研究的证据表明，癫痫发生和神经变性可能具有共同的潜在机制。然而，癫痫发生与神经变性之间的确切关联仍需充分阐明。减少异常网络过度兴奋的有针对性的干预可能构成一种治疗策略，可以将患者后来的神经退行性变化和随之而来的认知衰退的发生推迟很多年。凭借这一点，应该对阿尔茨海默病患者的癫痫发作进行早期诊断和治疗。迄今为止，在这种情况下还没有治疗癫痫活动的指南，这主要是由于缺乏足以回答相关问题的研究。因此，临床试验是强制性的，不仅要让临床医生了解阿尔茨海默病患者癫痫发作的症状管理，还要检测抗癫痫药物治疗是否具有缓解疾病的作用。此外，将阿尔茨海默氏病动物模型的应用扩展到合并症（例如癫痫）以揭示癫痫发作的潜在机制并更好地定义它们在认知能力下降中的作用将是至关重要的。