Multiple sclerosis and epileptic seizures.
BACKGROUND
The association between epilepsy and multiple sclerosis (MS) is not a coincidence.


OBJECTIVE
Our objective was to compare MS patients with or without history of seizures.


METHODS
In a population of 5041 MS patients, we identified 102 (2%) patients with epileptic seizures. In 67 patients (1.3%), epileptic seizure could not be explained by any cause other than MS.


RESULTS
In these 67 patients, the median age at occurrence of the first epileptic seizure was 33 years. Epilepsy was the initial clinical manifestation of MS in seven patients. In total, 62 patients (92.5%) presented only one or a few seizures, and 18 patients (27%) presented at least one episode of status epilepticus, fatal in two. Compared with MS patients without epilepsy, there was no difference in gender, type of MS course and time from onset of MS to the progressive phase. Conversely, the median age at MS onset was earlier (25.0 years vs. 30, p < 0.0001) and there was a trend for a shorter time from MS onset to non-reversible disability.


CONCLUSIONS
Our study confirms an increased risk of epileptic seizures in MS patients. It underlines that seizures may be the first observable symptom in MS and the frequency and seriousness of status epilepticus.
Catenoix
H
H
Service de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France. helene.catenoix@chu-lyon.fr
Marignier
R
R
Ritleng
C
C
Dufour
M
M
Mauguière
F
F
Confavreux
C
C
Vukusic
S
S
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D016009:Chi-Square Distribution; D002648:Child; D004185:Disability Evaluation; D018450:Disease Progression; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013226:Status Epilepticus / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D007155:Immunologic Factors