the dementia seizure spectrum™
A practical, research-informed framework for recognizing and describing seizure-related events in dementia.
The Dementia Seizure Spectrum™ (DSS) is a framework that helps families, caregivers, and clinicians recognize and describe the range of neurological changes that can reflect seizure-related activity in dementia. These changes are often brief, subtle, or mistaken for typical dementia symptoms, which makes them difficult to identify without a clear structure.
The DSS organizes these patterns into observable domains that can be described consistently. It links what caregivers notice in daily care with what clinical research has shown about seizure expression in dementia.”
Defining the framework
The DSS is a structured framework that describes how seizure activity may appear in dementia. It organizes observable and clinically meaningful seizure-related changes into four domains. These domains do not represent stages or severity. They support clearer observation, improved pattern recognition, and more consistent communication between caregivers and clinicians.
why it Matters
Seizure activity in dementia is frequently overlooked because the changes are brief, resemble typical dementia symptoms, or return to baseline quickly. Without a framework, important information may be missed and patterns remain unclear.
The DSS helps by:
- Organizes observations into a clear, structured model
- Improving recognition of meaningful patterns
- Supporting communication when behaviors change suddenly
- Connecting everyday observations with what is known clinically
- Reducing confusion caused by inconsistent descriptions
- Highlighting events that may require clinical attention
The goal of the DSS is clarity, not diagnosis. It helps everyone involved describe what they see in a consistent and useful way.
the four domains
These categories are not for assigning labels during care. DSS offers a structured way to understand and describe the types of neurological changes that may appear in dementia.
Subclinical Activity
In Practice
Brief pauses, sudden disengagement, or moments of being unexpectedly distant. The person may stop speaking mid-sentence or appear unaware for a few seconds before returning to baseline.
Clinically
Often associated with epileptiform activity or cortical irritability that produces no visible motor or behavioral signs.
Subtle Behavioral Events
In Practice
Short episodes easily mistaken for inattention or dementia-related changes. These may include blank staring, momentary unresponsiveness, or shifts in awareness.
Clinically
Often consistent with focal impaired awareness seizures or non-convulsive events. These overlap with behaviors labeled as apathy, sundowning, or disorientation.
Motor Phenomena
In Practice
Small or sudden movements that seem new or unusual, such as jerks, twitches, brief stiffness, or motions mistaken for tremor or restlessness.
Clinically
May reflect cortical myoclonus, negative myoclonus, focal motor activity, or short tonic movements.
Recognizable Seizures
In Practice
More noticeable events such as repetitive movements, stiffening, shaking, or sudden changes in awareness.
Clinically
Includes focal or generalized motor seizures with identifiable clinical features.
Why seizure-related events are missed
Seizure activity in dementia is difficult to recognize because many signs are brief, resemble typical dementia symptoms, and vary between observers. Without a clear structure for describing these changes, early patterns can be overlooked.
- Episodes are brief
- Signs resemble usual dementia symptoms
- Individuals often return to baseline quickly
- Different caregivers observe different behaviors
- Descriptions vary between observers
- Patterns are hard to see without structured documentation
The DSS helps make these events visible, understandable, and easier to communicate.
how DSS Supports seizureSafe
DSS is the clinical backbone of SeizureSafe.
SeizureSafe Home
Uses the DSS framework to help caregivers recognize possible seizure-related changes and describe what they observe clearly during medical visits.
SeizureSafe Pro
Uses the DSS framework to support care teams with clearer observation, consistent communication, and improved recognition of seizure-related patterns.
what it is Not
- DSS is not a diagnosis.
- DSS does not determine whether a person is having seizures.
- DSS is not a staging or progression model.
- DSS does not replace medical evaluation.
- DSS does not predict outcomes or severity.
The framework is designed to support recognition and communication, not diagnosis.
next steps
Learn more about how to recognize seizure-related changes at SeizureSafe Home.
See how DSS supports clinical teams through SeizureSafe Pro.