Coexistence of epilepsy or seizure and multiple sclerosis; review of the literature with a single center experience

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-20 DOI:10.1016/j.msard.2024.105948

Furkan Saridas , Gizem Mesut , Rifat Ozpar , Emine Rabia Koc , Bahattin Hakyemez , Aylin Bican Demir , Omer Faruk Turan

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引用次数: 0

Abstract

Objectives

There is evidence that the inflammatory demyelinating disorder in Multiple Sclerosis (MS) is associated with acute seizures and epilepsy. Additionally, the likelihood of developing epilepsy increases with neurodegeneration. This study aims to reveal the clinical and radiological features of MS-epilepsy/seizure coexistence.

Methods

Among all patients diagnosed with MS that we followed in our center between April 2002 and July 2023, patients with a single seizure history or diagnosed with epilepsy (MS-seizure/epilepsy) were randomized 1:1 in terms of age and gender with MS patients without a diagnosis of epilepsy or seizures. Clinical (comorbidities, annualized relapse rate, disability, seizures during attacks, initial diagnosis, disease duration, disease-modifying therapies (DMTs), refractory epilepsy, anti-seizure drugs), electroencephalography (EEG) and MRI (lesion localization and new lesion(s)) data were retrospectively evaluated.

Results

The mean EDSS was 4.07±2.81. 29.4 % of patients had progressive MS (n = 10). Refractory epilepsy was 52.9 % (n = 18), and SE history was 14.7 % (n = 5). Pathology was detected in 69.7 % (n = 23) of patients in the EEG. The most common slow wave activation was detected in 51.5 % (n = 17). Refractory epilepsy was more common in cases under 45 and patients with lesions in thalamic localization. Lesions in the temporal and thalamic regions and cerebral atrophy were more common in the MS-seizure/epilepsy group.

Conclusion

Patients with demyelinating lesions in the temporal and thalamic regions should be questioned more carefully for epilepsy, and an EEG should be performed in case of clinical suspicion. Since thalamus lesions are more common in patients with refractory epilepsy, anti-seizure treatment strategies should be applied more carefully. The presence of atrophy on MRI confirms the link between neurodegeneration processes and the development of epilepsy.

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癫痫或癫痫发作与多发性硬化症并存；文献综述与单中心经验

目的有证据表明，多发性硬化症（MS）的炎症性脱髓鞘障碍与急性癫痫发作和癫痫有关。此外，发生癫痫的可能性随着神经变性而增加。本研究旨在揭示多发性硬化症-癫痫/癫痫发作共存的临床和放射学特征。方法在 2002 年 4 月至 2023 年 7 月期间，在本中心随访的所有确诊为多发性硬化症的患者中，将有单次癫痫发作史或确诊为癫痫（多发性硬化症-癫痫/癫痫）的患者与未确诊为癫痫或癫痫发作的多发性硬化症患者按年龄和性别 1:1 随机分组。对患者的临床（合并症、年复发率、残疾程度、发作时的癫痫发作、最初诊断、病程、疾病改变疗法（DMT）、难治性癫痫、抗癫痫药物）、脑电图（EEG）和磁共振成像（病灶定位和新病灶）数据进行了回顾性评估。29.4%的患者为进行性多发性硬化症（n = 10）。难治性癫痫占52.9%（18人），SE病史占14.7%（5人）。69.7%的患者（n = 23）在脑电图中发现了病理变化。最常见的慢波激活在 51.5 %（17 人）中被检测到。难治性癫痫多见于 45 岁以下的病例和丘脑局部病变的患者。颞部和丘脑病变以及脑萎缩在多发性硬化症发作/癫痫组中更为常见。由于丘脑病变在难治性癫痫患者中更为常见，因此应更谨慎地采用抗癫痫治疗策略。核磁共振成像上出现的萎缩证实了神经变性过程与癫痫发病之间的联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.