| Popis: |
The aim of the study was to evaluate the association between multiple sclerosis (MS)and epilepsy, to analyze clinical characteristics of epilepsy in patients with MS, and to evaluate electroencephalography (EEG)findings and response to antiepileptic drug treatment. Medical records of 146 of clinically definite MS diagnosed at Pula General Hospital during a 20-year period (1985-2005) were reviewed. All patients were submitted to standard EEG and magnetic resonance imaging (MRI) studies. None of the patients had any evidence of other potentially epileptogenic pathology. Among 146 consecutive MS patients there were 11 (7, 53%) patients with epileptic seisures, 6 female and 5 male, mean age 38, 09 (range 23-53) years. In 3 cases epilepsy preceded the onset of MS, concurrent onset of the two diseases was recorded in 5 patients, and in 3 patients epilepsy followed the onset of MS. The seizures were generalized in 4, partial sensory or motor with secondary generalization in two, simple partial motor in 3 patients, and partial complex in 1 patient. Two patients experienced episodes of status epilepticus. Abnormal EEG pattern was found in 8 patients. EEG showed paroxysmal discharges in 2 patients. An epileptic focus in EEG was evident in 1 patient and diffuse discharges were observed in 5 patients. MRI showed numerous plaques of demyelinization which involved the cortical and subcortical areas in 8 patients, and focal cortical atrophy in 3 patients. In 7 patients, the seizures disappeared completely during the follow up, i.e. by December 2005. Accordingly, MS is associated with a higher risk of epilepsy than as compared with the general population. Partial epilepsies with or without socondary generalization are the usual pattern. In rare cases status epilepticus has been reported. The occurence of epileptiform abnormalities on EEG in patients with MS is rare. The lesions involved in the pathogenesis of epilepsy are plaques of demyelinization which affect the cortical or subcortical areas. The seizures were generally well controlled with antiepileptic drugs. There was no clear correlation between the severity of MS and epilepsy. The reason for this increased risk is unclear and needs further investigation |
