Shen Chun-Hong, Zheng Yang, Cai Meng-Ting, Yang Fan, Fang Wei, Zhang Yin-Xi, Ding Mei-Ping
Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Neurology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China.
Mult Scler Relat Disord. 2020 Jul;42:102057. doi: 10.1016/j.msard.2020.102057. Epub 2020 Mar 14.
Recent reports have suggested that seizures may be a component of the clinical presentation in myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease. We aimed to conduct a systematic review and meta-analysis to comprehensively evaluate the occurrence of epileptic seizures in the disease.
We searched PubMed, MEDLINE and EMBASE for studies reporting the occurrence of acute symptomatic seizures in MOG-Ab-associated disease. Fixed or random effects model was used to pool results across studies with a meta-analysis.
A total of 14 studies met the inclusion criteria. Overall, acute symptomatic seizures were observed in 20.5% (95% confidence interval [CI] 13.7%-30.7%, I=60.6%) patients with MOG-Ab-associated disease, and in a similar proportion of children respectively (20.0%; 95% CI 14.3%-27.8%, I=7.0%). The pooled probability of seizure occurrence in males was 30.1% (95% CI 17.5%-52%, I=0.0%) while that in females was much lower (12.0%; 95% CI 5.5%-26.4%, I=0.0%). Furthermore, when we focused on those with acute disseminated encephalomyelitis-like phenotype, 37.3% patients experienced seizures (95% CI 21.0%-66.3%, I=55.8%).
Our study suggested that epileptic seizures were common in MOG-Ab-associated disease and offered insight into associated factors that contribute to the occurrence of seizures. Future studies with explicit evaluation are required.
近期报告提示,癫痫发作可能是髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)相关疾病临床表现的一部分。我们旨在进行一项系统评价和荟萃分析,以全面评估该疾病中癫痫发作的发生率。
我们检索了PubMed、MEDLINE和EMBASE,查找报告MOG-Ab相关疾病中急性症状性癫痫发作发生率的研究。采用固定效应或随机效应模型对各研究结果进行荟萃分析合并。
共有14项研究符合纳入标准。总体而言,20.5%(95%置信区间[CI]13.7%-30.7%,I²=60.6%)的MOG-Ab相关疾病患者出现急性症状性癫痫发作,儿童中的比例相似(20.0%;95%CI 14.3%-27.8%,I²=7.0%)。男性癫痫发作的合并概率为30.1%(95%CI 17.5%-52%,I²=0.0%),而女性则低得多(12.0%;95%CI 5.5%-26.4%,I²=0.0%)。此外,当我们关注具有急性播散性脑脊髓炎样表型的患者时,37.3%的患者出现癫痫发作(95%CI 21.0%-66.3%,I²=55.8%)。
我们的研究表明,癫痫发作在MOG-Ab相关疾病中很常见,并深入了解了导致癫痫发作的相关因素。需要开展有明确评估的未来研究。