Department of Neurology, Faculty of Medicine, Istanbul University, Çapa, 34390, Istanbul, Turkey.
Acta Neurol Belg. 2013 Dec;113(4):421-6. doi: 10.1007/s13760-013-0210-x. Epub 2013 May 22.
Multiple sclerosis (MS) and epilepsy are common disorders, the co-occurrence of which has been of considerable interest. This study aimed to evaluate the prevalence and clinical features of epileptic seizures in patients with definite MS including those with pediatric onset (≤16 years of age). Out of 2,300 patients with definite MS followed in our outpatient clinic, 36 with epileptic seizures were identified. In this cohort, 8 out of 146 pediatric cases had seizures. The clinical and demographic features of the patients were recorded. Multiple logistic regression model with the occurence of seizures as the dependent variable was performed to identify the risk factors for seizure occurrence in MS patients. The prevalence of epileptic seizures was 1.5% in definite MS patients, 1.3% in adult-onset (comparable to seizure prevalence in the general population) and 5.5% in pediatric MS patients (≤16 years old). Twenty-six of 36 (72%) patients with MS and epilepsy developed recurrent seizures after the first epileptic seizure. Mean annual relapse rate (p ≤ 0.001), mean expanded disability status scale (EDSS) score (p = 0.004) and the ratio of patients with pediatric onset (p = 0.01) were higher in MS patients with seizures. In the multiple logistic regression analysis, age at MS onset and EDSS at the last examination were found to be predictors of seizure occurrence. Occurrence of seizures during the clinical course of MS appears to be associated with early-onset and increased disease severity and might be coincidental in adults.
多发性硬化症 (MS) 和癫痫是常见疾病，两者同时存在引起了广泛关注。本研究旨在评估明确诊断为 MS 的患者中癫痫发作的患病率和临床特征，包括儿童起病（≤16 岁）的患者。在我们的门诊随访的 2300 例明确 MS 患者中，发现有 36 例伴有癫痫发作。在该队列中，146 例儿科病例中有 8 例出现癫痫发作。记录了患者的临床和人口统计学特征。采用多因素逻辑回归模型，以癫痫发作为因变量，确定 MS 患者发生癫痫的危险因素。明确 MS 患者中癫痫发作的患病率为 1.5%，成人起病者为 1.3%（与普通人群的癫痫患病率相当），儿童起病者为 5.5%（≤16 岁）。36 例伴有 MS 和癫痫的患者中，26 例（72%）在首次癫痫发作后出现复发性癫痫。MS 伴癫痫患者的年平均复发率（p≤0.001）、扩展残疾状态量表（EDSS）评分均值（p=0.004）和儿童起病比例（p=0.01）均较高。多因素逻辑回归分析显示，MS 发病年龄和最后一次检查时的 EDSS 是癫痫发作的预测因素。MS 病程中出现癫痫发作似乎与发病年龄早和疾病严重程度增加有关，而在成人中可能是巧合。
