Gurtubay I G, Gila L, Morales G, Gállego-Culleré J, Ayuso M T, Manubens J M
Servicio de Neurofisiología Clínica, Hospital Virgen del Camino, Pamplona, España.
Rev Neurol. 2000;30(9):827-32.
Although epileptic seizures are uncommon in multiple sclerosis they are more prevalent than in the general population, which supports an aetiological relationship. Similarly in a considerable proportion of patients with multiple sclerosis and epileptic seizures, alterations in magnetic resonance and electroencephalogram studies which could be correlated with the clinical features of epilepsy were observed. Nevertheless, it is difficult to establish definite clinical characteristics in these patients since the underlying pathogenic mechanisms are poorly understood and there is great variability with regard to the type of seizure, point at which this occurs during the course of the disease, degree of recurrence and other aspects.
We report the clinical, electroencephalographical and neuroimaging findings of seven patients with multiple sclerosis who had epileptic seizures and those in whom there was no evidence of other potentially epileptogenic pathology. In two patients the epileptic seizures formed part of the first episode of their illness. One patient presented more than one type of epileptic seizure. These seizures were generalized in two cases, partial sensory and/or motor with secondary generalization in three, simple partial motor in one and partial complex in two. The epileptic seizures coincided with other clinical features of episodes in three cases and the electroencephalogram showed anomalies in five cases.
The findings observed were of a wide variety, as was found in other reported series. We point out certain correlations between the clinical data, magnetic resonance and electroencephalogram which may help to orientate the management of these patients.
尽管癫痫发作在多发性硬化症中并不常见,但比普通人群更为普遍,这支持了一种病因学关系。同样,在相当一部分患有多发性硬化症和癫痫发作的患者中,观察到磁共振和脑电图研究中的改变,这些改变可能与癫痫的临床特征相关。然而,由于潜在的致病机制了解甚少,且癫痫发作类型、疾病过程中发作时间点、复发程度及其他方面存在很大差异,因此难以确定这些患者明确的临床特征。
我们报告了7例患有癫痫发作且无其他潜在致痫性病理证据的多发性硬化症患者的临床、脑电图和神经影像学检查结果。2例患者的癫痫发作是其疾病首发症状的一部分。1例患者出现不止一种类型的癫痫发作。这些发作中,2例为全身性发作,3例为部分感觉性和/或运动性发作继发全身性发作,1例为单纯部分运动性发作,2例为部分复杂性发作。3例患者的癫痫发作与发作的其他临床特征同时出现,5例患者的脑电图显示异常。
观察到的结果多种多样,与其他报道系列中发现的情况相同。我们指出了临床数据、磁共振和脑电图之间的某些相关性,这可能有助于指导这些患者的管理。