title: [Epilepsy as the first sign of multiple sclerosis].
abstract: BACKGROUND
  Epileptic crises are uncommon in patients with multiple sclerosis. However, epilepsy is commoner in these patients than in the general population. An epileptic crisis as the presenting feature of multiple sclerosis is even rarer. The lesions involved in the pathogenesis of these crises are plaques of demyelinization which affect the cortical or subcortical areas. Other factors, some of which are still not clearly understood, such as the fibre, electrolytic changes, size of the plaque, reactive gliosis and the enzyme (Na(+)-K+)ATPase, seem also to play a part in the production mechanism. Magnetic resonance is a very sensitive technique used in the detection of demyelinating lesions during the acute phase. The sensitivity is further increased by the use of gadolinium.
  
  
  CONCLUSIONS
  We present two cases of multiple sclerosis which presented as epileptic crises. In one there were generalized tonic-clonic crises and in the other partial sensitive crises. We mention the EEG findings, CSF analysis and neuroimaging diagnostic techniques.
authors.affiliation: Sección de Neurorradiologia, Hospital Miguel Servet, Zaragoza, España.
authors.forename: S
authors.initials: S
authors.lastname: García-Asensio
authors.forename: J
authors.initials: J
authors.lastname: López del Val
authors.forename: R
authors.initials: R
authors.lastname: Barrena
authors.forename: S
authors.initials: S
authors.lastname: Guelbenzu
authors.forename: L
authors.initials: L
authors.lastname: Mazas
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology; D003711:Demyelinating Diseases; D004829:Epilepsy, Generalized / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology; D009431:Neural Conduction
vernacular_title: Epilepsia como primera manifestación de esclerosis múltiple.