Epileptic seizures strike long before dementia sets in—and doctors may be missing the signs in thousands of patients.
Key Points at a Glance
- New study finds epilepsy far more common in patients with frontotemporal dementia (FTD) than previously known.
- Seizures can appear years before dementia is diagnosed, often overlooked due to symptom similarity.
- Study used one of the world’s largest FTD patient datasets from Finland’s university hospitals.
- Untreated epilepsy may worsen patient outcomes and diminish quality of life.
Epilepsy is emerging as a silent companion to one of the most devastating brain disorders. A groundbreaking study led by researchers from the University of Eastern Finland and the University of Oulu has revealed that people suffering from frontotemporal dementia (FTD) are far more likely to experience epileptic seizures—long before any cognitive decline is detected.
Published in JAMA Neurology, the study analyzed over 12,000 medical records, identifying 245 patients with FTD and comparing them to both Alzheimer’s patients and healthy controls. The results were striking: epilepsy was significantly more prevalent in FTD patients across every phase of the disease.
“It was surprising how many patients had experienced seizures as early as ten years before receiving an FTD diagnosis,” said lead author and neurologist Dr. Annemari Kilpeläinen. This discovery rewrites what clinicians thought they knew about early-stage dementia, particularly since epilepsy has been more classically associated with Alzheimer’s, not FTD.
The data revealed that five years after diagnosis, about 11% of FTD patients had epilepsy—more than in Alzheimer’s or healthy individuals. Even more telling, patients were more frequently prescribed epilepsy medications, reinforcing that these weren’t isolated or misdiagnosed events.
What makes this particularly troubling is that the symptoms of FTD—disorientation, blank stares, sudden mood shifts—can mimic or mask epileptic activity. The overlap may cause doctors to miss seizures entirely or misattribute them as cognitive decline. And that has real consequences: untreated epilepsy can accelerate deterioration, reduce functional ability, and impair quality of life.
Dr. Eino Solje, the project’s principal investigator, notes that this opens new questions for science. “Could some FTD symptoms actually be driven by disruptions in the brain’s electrical systems? Are epilepsy and FTD rooted in the same pathophysiological mechanisms?” he asks. If so, early detection of seizures might even delay dementia’s march.
The Finnish team’s research stands out not only for its scope—spanning more than a decade of hospital data—but also for its cross-disciplinary approach. The project integrated legal, neurological, and data science fields, with the support of top-tier epilepsy research centers at Kuopio and Oulu University Hospitals. These facilities are part of the international EpiCARE network, ensuring that the insights gained can reverberate across Europe and beyond.
By linking seizures to the early stages of FTD, the study reshapes diagnostic roadmaps and clinical priorities. Patients who exhibit seizure-like symptoms may need closer neurological monitoring—even if their memory appears intact. “This knowledge could help us recognize FTD sooner, tailor treatments earlier, and perhaps even change the trajectory of the disease,” says Dr. Kilpeläinen.
The findings urge neurologists and general practitioners alike to consider epilepsy not just as a coexisting condition, but potentially as an early harbinger of a disease that robs people of personality, memory, and eventually, identity.
Source: University of Eastern Finland
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