Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Street, Dongcheng district, Beijing 100730, China.
Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuaifuyuan Street, Dongcheng district, Beijing 100730, China.
Mult Scler Relat Disord. 2019 Jan;27:281-288. doi: 10.1016/j.msard.2018.11.007. Epub 2018 Nov 10.
Little is known about the incidence and characteristics of acute epileptic seizures in myelin oligodendrocyte glycoprotein encephalomyelitis (MOG-EM) and neuromyelitis optica spectrum disorder (NMOSD). In this study, we compared the incidence and characteristics of acute epileptic seizures in MOG-EM and NMOSD patients.
MOG-EM (n = 61) and NMOSD (n = 565) cases obtained from the MSNMOBase (2011-2018) were retrospectively reviewed.
Acute epileptic seizures were observed in 13 (21.3%) patients with MOG-EM and two (0.4%) patients with NMOSD (P < 0.001). In both MOG-EM and NMOSD patients, more than half of seizures were single and of focal onset; slow wave and cortical/subcortical lesions were the most common abnormalities. In MOG-EM patients, no difference was found in the proportion of single seizure with and without anti-epileptic drugs (AEDs; 64.3% vs. 45.5%, P = 0.435). Long-term AED use did not significantly reduce the occurrence of acute epileptic seizures, which was 66.7% before and after treatment. In patients with MOG-EM and NMOSD, mycophenolate mofetil significantly reduced acute epileptic seizure occurrence (P = 0.024).
Acute epileptic seizures were more common in MOG-EM patients than in NMOSD patients. The long-term use of AEDs might be unnecessary given the use of immunotherapy in cases of MOG-EM.
关于髓鞘少突胶质细胞糖蛋白脑炎（MOG-EM）和视神经脊髓炎谱系疾病（NMOSD）患者中急性癫痫发作的发生率和特征知之甚少。在这项研究中，我们比较了 MOG-EM 和 NMOSD 患者中急性癫痫发作的发生率和特征。
回顾性分析了 MSNMOBase（2011-2018 年）中 61 例 MOG-EM 和 565 例 NMOSD 病例。
在 61 例 MOG-EM 患者中有 13 例（21.3%）发生急性癫痫发作，在 565 例 NMOSD 患者中有 2 例（0.4%）发生急性癫痫发作（P<0.001）。在 MOG-EM 和 NMOSD 患者中，超过一半的癫痫发作是单发和局灶性发作；慢波和皮质/皮质下病变是最常见的异常。在 MOG-EM 患者中，未服用抗癫痫药物（AED）和服用 AED 的单发性癫痫发作比例无差异（64.3%比 45.5%，P=0.435）。长期 AED 使用并不能显著降低急性癫痫发作的发生，治疗前后分别为 66.7%。在 MOG-EM 和 NMOSD 患者中，霉酚酸酯显著降低了急性癫痫发作的发生（P=0.024）。
MOG-EM 患者急性癫痫发作比 NMOSD 患者更常见。鉴于 MOG-EM 病例中免疫治疗的应用，长期使用 AED 可能是不必要的。
