Uwe Klaus Zettl1, Matthias Grothe2, Friederike Neuß3, Felix von Podewils3, Zhong Irene Wang4, Marie Süße3. 1. Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany. 2. Department of Neurology, University Medicine Greifswald, Ferdinand-Sauerbruchstraße, 17475, Greifswald, Germany. matthias.grothe@med.uni-greifswald.de. 3. Department of Neurology, University Medicine Greifswald, Ferdinand-Sauerbruchstraße, 17475, Greifswald, Germany. 4. Epilepsy Center, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Abstract
BACKGROUND: Multiple sclerosis (MS) is accompanied by an increased risk of epileptic seizures, but data with a detailed description of the competing causes are lacking. METHODS: We aimed to describe a cohort of patients with both MS and epileptic seizures in a retrospective, population-based study. RESULTS: We included 59 out of 2285 MS patients who had at least one epileptic seizure. Out of them, 22 had seizures before the diagnosis of MS, whereas epileptic seizures occurred after MS diagnosis in 37 patients, resulting in a total prevalence of epileptic seizures in MS of 2.6%. Competing causes could be found in 50.8% (30/59) of all patients, with 40.9% (9/22) compared to 56.8% (21/37) of the MS patients with seizures before vs after MS diagnosis. The main alternative causes were traumatic brain injury and cerebral ischemia accounting for more than 30% of the patients, with no difference between the subgroups. 33.3% and 55.6% of MS patients with seizures before/after MS diagnosis had documented pathological EEG alterations. CONCLUSION: A remarkable percentage of MS patients with epileptic seizures do have alternative competing causes at the time of the first seizure. A detailed diagnostic setup including patient history, EEG and MRI is recommended in the evaluation and choice for the best treatment.
BACKGROUND:Multiple sclerosis (MS) is accompanied by an increased risk of epileptic seizures, but data with a detailed description of the competing causes are lacking. METHODS: We aimed to describe a cohort of patients with both MS and epileptic seizures in a retrospective, population-based study. RESULTS: We included 59 out of 2285 MSpatients who had at least one epileptic seizure. Out of them, 22 had seizures before the diagnosis of MS, whereas epileptic seizures occurred after MS diagnosis in 37 patients, resulting in a total prevalence of epileptic seizures in MS of 2.6%. Competing causes could be found in 50.8% (30/59) of all patients, with 40.9% (9/22) compared to 56.8% (21/37) of the MSpatients with seizures before vs after MS diagnosis. The main alternative causes were traumatic brain injury and cerebral ischemia accounting for more than 30% of the patients, with no difference between the subgroups. 33.3% and 55.6% of MSpatients with seizures before/after MS diagnosis had documented pathological EEG alterations. CONCLUSION: A remarkable percentage of MSpatients with epileptic seizures do have alternative competing causes at the time of the first seizure. A detailed diagnostic setup including patient history, EEG and MRI is recommended in the evaluation and choice for the best treatment.