Alaska Brain Center, LLC, Wasilla, Alaska, USA.
Epileptic Disord. 2011 Dec;13(4):401-10. doi: 10.1684/epd.2011.0468.
The incidence of seizures is generally accepted to be greater in patients with multiple sclerosis (MS) than in the general population, and rarely, MS can initially present as seizure. To present a case report of seizure as the initial symptom of MS, to quantify the occurrence of seizures among MS patients, and to classify patients according to when seizures occur relative to onset of MS. The medical history of patients presenting with MS and seizure in our clinic was examined. In addition, 25 scientific papers were reviewed and the number and characteristics of patients with MS and seizure recorded. Data from the literature review and from our own clinical series were combined and examined. Of the MS patients, 1.95% experienced seizures at any time during life. Patients experiencing seizures before MS diagnosis were classified into three categories: (a) 25 (7.3% of patients with MS and seizures) with seizure as the initial presentation of MS; (b) 27 (7.9%) with seizures appearing with other signs and symptoms of MS; and (c) 68 (20%) with seizures occurring years or an unknown period of time before MS onset. Seizure occurring as a symptom of MS relapse was found in 29 patients. The prevalence of seizures among MS patients was higher than that in the general population, indicating a relationship between seizures and MS. Seizures occurred before MS diagnosis in a small percentage of patients.
癫痫的发病率在多发性硬化症（MS）患者中通常高于普通人群，而且 MS 很少会以癫痫发作作为首发症状。本研究旨在报道 1 例以癫痫发作为首发症状的 MS 病例，定量评估 MS 患者癫痫发作的发生率，并根据癫痫发作与 MS 发病的时间关系对患者进行分类。我们对就诊于我科的以 MS 和癫痫发作为首发症状的患者的病史进行了回顾性分析。此外，还对 25 篇科学文献进行了综述，记录了 MS 合并癫痫患者的数量和特征。对文献回顾和我们的临床系列数据进行了综合分析。结果显示，MS 患者中癫痫发作的发生率为 1.95%。在 MS 诊断前发生癫痫的患者可分为以下 3 类：（a）25 例（MS 合并癫痫患者的 7.3%）以癫痫发作为 MS 的首发表现；（b）27 例（7.9%）以癫痫发作为 MS 的首发症状；（c）68 例（20%）癫痫发作发生在 MS 发病前数年或未知时间。29 例患者的癫痫发作为 MS 复发的症状。MS 患者的癫痫发生率高于普通人群，提示癫痫与 MS 之间存在一定的相关性。有一小部分患者在 MS 诊断前发生癫痫。
