Lisa Langenbruch1, Julia Krämer1, Sati Güler1, Gabriel Möddel1, Sophia Geßner2, Nico Melzer1, Christian E Elger1,3,4, Heinz Wiendl1, Thomas Budde5, Sven G Meuth1, Stjepana Kovac6. 1. Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany. 2. Institute of Medical Informatics, University of Münster, Albert-Schweitzer-Campus 1, Gebäude A11, 48149, Münster, Germany. 3. Beta Neurologie, Kompetenzzentrum für Epileptologie, Joseph-Schumpeter-Allee 15, 53277, Bonn, Germany. 4. Klinik für Neuropädiatrie, Charite, Berlin, Germany. 5. Institute of Physiology I, University of Münster, Robert-Koch-Straße 27a, 48149, Münster, Germany. 6. Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Germany. Stjepana.Kovac@ukmuenster.de.
Abstract
BACKGROUND: Seizures and epilepsy may substantially add to the burden of disease in multiple sclerosis (MS), whereas the exact prevalence and prognosis of seizures and epilepsy in patients with MS remains largely unknown. OBJECTIVES: We aimed to investigate the epidemiology and prognosis of seizures and epilepsy in MS. METHODS: We retrospectively analyzed a cohort of 4078 MS patients from a single tertiary referral clinic. RESULTS: After excluding 37 patients with unconfirmed MS and alternative seizure etiologies, we found seizures attributable to MS in 1.5% and epilepsy in 0.9% of patients. 40.4% of patients with a follow-up of at least twelve months experienced only a single seizure and 59.6% had recurring seizures. 39% of patients with recurrent seizures were considered drug-resistant, with 9.7% experiencing status epilepticus. Seizure recurrence after a first seizure depended significantly on the MS subtype and was seen more often if the first seizure occurred simultaneously with a MS relapse than in the absence of a relapse. CONCLUSION: Our study shows a lower number of seizures and epilepsy in MS than previously reported. While a single seizure in MS usually has a good prognosis, relapse-associated seizures and established epilepsy in MS may not be as benign as previously assumed.
BACKGROUND:Seizures and epilepsy may substantially add to the burden of disease in multiple sclerosis (MS), whereas the exact prevalence and prognosis of seizures and epilepsy in patients with MS remains largely unknown. OBJECTIVES: We aimed to investigate the epidemiology and prognosis of seizures and epilepsy in MS. METHODS: We retrospectively analyzed a cohort of 4078 MS patients from a single tertiary referral clinic. RESULTS: After excluding 37 patients with unconfirmed MS and alternative seizure etiologies, we found seizures attributable to MS in 1.5% and epilepsy in 0.9% of patients. 40.4% of patients with a follow-up of at least twelve months experienced only a single seizure and 59.6% had recurring seizures. 39% of patients with recurrent seizures were considered drug-resistant, with 9.7% experiencing status epilepticus. Seizure recurrence after a first seizure depended significantly on the MS subtype and was seen more often if the first seizure occurred simultaneously with a MS relapse than in the absence of a relapse. CONCLUSION: Our study shows a lower number of seizures and epilepsy in MS than previously reported. While a single seizure in MS usually has a good prognosis, relapse-associated seizures and established epilepsy in MS may not be as benign as previously assumed.
Authors: D V Sokic; N Stojsavljevic; J Drulovic; I Dujmovic; S Mesaros; M Ercegovac; V Peric; G Dragutinovic; Z Levic Journal: Epilepsia Date: 2001-01 Impact factor: 5.864
Authors: Iris E Martínez-Juárez; Elmer López-Meza; Maria del Carmen Fernández González-Aragón; Jesús Ramírez-Bermúdez; Teresa Corona Journal: Epilepsy Res Date: 2009-03-28 Impact factor: 3.045
Authors: Chris H Polman; Stephen C Reingold; Gilles Edan; Massimo Filippi; Hans-Peter Hartung; Ludwig Kappos; Fred D Lublin; Luanne M Metz; Henry F McFarland; Paul W O'Connor; Magnhild Sandberg-Wollheim; Alan J Thompson; Brian G Weinshenker; Jerry S Wolinsky Journal: Ann Neurol Date: 2005-12 Impact factor: 10.422
Authors: W I McDonald; A Compston; G Edan; D Goodkin; H P Hartung; F D Lublin; H F McFarland; D W Paty; C H Polman; S C Reingold; M Sandberg-Wollheim; W Sibley; A Thompson; S van den Noort; B Y Weinshenker; J S Wolinsky Journal: Ann Neurol Date: 2001-07 Impact factor: 10.422