A Case Series of Concomitant Parkinson’s Disease and Cryptogenic Epilepsy (P4.314)

OBJECTIVE: Parkinson’s disease (PD) and cryptogenic epilepsy are not regularly described as comorbid disorders. We report a case series of individuals with coexisting PD and cryptogenic epilepsy. BACKGROUND: PD and cryptogenic epilepsy are prevalent neurological disorders that affect the US elderly. Yet, rarely are they reported together. As Lewy Bodies (LB) progress to involve cortical regions, many PD patients develop cognitive impairment and dementia (PDD), which can have characteristics similar to epileptic manifestations. While these characteristics can be attributed to widespread LB pathology, they may also be due an underlying seizure disorder and lead to the under-diagnosis of epilepsy in PD patients. DESIGN/METHODS: Among 1,200 patients with idiopathic PD at our institution, we identified seven with coexisting cryptogenic seizure disorder. All subjects were diagnosed with PD and epilepsy by movement disorder and epilepsy specialists. RESULTS: Of the 6 subjects included (3 Men, 3 Women; Ages 49-85), 2 had seizures after PD-onset (10 and 7 years after PD-onset), 3 had adult-onset seizures before PD (6, 14, and 15 years before PD-onset), and 1 subject had pediatric-onset seizures before PD (age 13). Three had complex partial seizures, one of whom developed 2 secondary generalized seizures, and three had simple partial seizures. At last observation, one was HY four subjects had some degree of cognitive impairment. CONCLUSIONS: Although non-motor symptoms such as fluctuations in cognition, periods of staring into space, transient loss of consciousness, and hallucinations can be related to a advanced PD, they could also represent seizure activity. Therefore, patients with such symptoms may merit an epilepsy work-up, as proper diagnosis and treatment of an underlying seizure disorder could improve quality of life. This series of patients makes a case for increasing awareness of concomitant PD and cryptogenic epilepsy. Disclosure: Dr. Son has nothing to disclose. Dr. Biagioni has nothing to disclose. Dr. Kaminsky has nothing to disclose. Dr. Gurevich has nothing to disclose. Dr. Stone has nothing to disclose. Dr. Gilbert has nothing to disclose. Dr. Nirenberg has nothing to disclose. Dr. Di Rocco has nothing to disclose.