Sokic D V, Stojsavljevic N, Drulovic J, Dujmovic I, Mesaros S, Ercegovac M, Peric V, Dragutinovic G, Levic Z
Institute of Neurology, Clinical Center of Serbia, Dr Subotića 6, Belgrade 11000, Yugoslavia.
Epilepsia. 2001 Jan;42(1):72-9. doi: 10.1046/j.1528-1157.2001.48699.x.
In patients with multiple sclerosis (MS), epileptic seizures occur more frequently than in the general population. The aim of this study was to analyze clinical characteristics of epilepsy in patients with MS, potential correlation between the semiology of seizures, EEG and magnetic resonance imaging (MRI) findings in these patients, as well as to examine the response to anticonvulsant therapy.
In a series of 268 consecutive patients with definite MS hospitalized at the Institute of Neurology, Belgrade, we identified 20 (7.5%) patients with seizures or epilepsy. All patients with seizures or epilepsy were submitted to standard EEG and brain MRI with gadopentetate dimeglumine.
In four patients, epilepsy occurred 1-5 years before other clinical manifestations of MS. Eight patients had seizures only during MS relapses (provoked seizures). In two of them, seizures were the only manifestations of relapse. In 12 patients, seizures occurred regardless of the phase of MS (chronic epilepsy). In the majority of patients, seizures were partial with secondary generalization. Five patients experienced episodes of status epilepticus, and they all had dementia. Abnormal EEG pattern was found in 11 patients. Brain MRI disclosed cortical-subcortical lesions in nine patients and focal cortical atrophy in one, whereas in the remaining patients, findings were inconclusive. Probable EEG-MRI-seizure type correlation existed in 10 patients.
Our data suggest that epilepsy may represent an initial symptom of MS and a single clinical manifestation of a relapse, and further support the assumption of the existing correlation between the presence of cortical-subcortical lesions and epileptic seizures or epilepsy in patients with MS.
在多发性硬化症（MS）患者中，癫痫发作比普通人群更为频繁。本研究的目的是分析MS患者癫痫的临床特征、发作症状学、脑电图（EEG）和磁共振成像（MRI）结果之间的潜在相关性，以及研究抗惊厥治疗的反应。
在贝尔格莱德神经病学研究所连续收治的268例确诊MS患者中，我们确定了20例（7.5%）有癫痫发作或患有癫痫的患者。所有有癫痫发作或患有癫痫的患者均接受了标准脑电图和钆喷酸葡胺增强脑MRI检查。
4例患者在MS的其他临床表现出现前1 - 5年发生癫痫。8例患者仅在MS复发时发作（诱发性发作）。其中2例患者，癫痫发作是复发的唯一表现。12例患者无论MS处于何阶段均有发作（慢性癫痫）。大多数患者发作类型为部分性发作继发全身性发作。5例患者经历癫痫持续状态发作，且均患有痴呆症。11例患者脑电图模式异常。脑MRI显示9例患者有皮质 - 皮质下病变，1例有局灶性皮质萎缩，其余患者检查结果不明确。10例患者脑电图 - MRI - 发作类型之间可能存在相关性。
我们的数据表明，癫痫可能是MS的初始症状和复发的单一临床表现，并进一步支持了MS患者皮质 - 皮质下病变的存在与癫痫发作或癫痫之间存在相关性的假设。
