Epileptic and non-epileptic seizures in multiple sclerosis

Abstract

Knowledge concerning the relationship between multiple sclerosis and epilepsy is reviewed. Epidemiological studies have established that epileptic seizures are more frequent in multiple sclerosis than predicted by chance. Partial epilepsies with focal seizures often with atypical symptoms and with or without secondary generalisation are the usual pattern. In the survey special emphasis is laid on the direct correlation between paroxysmal phenomena and plaques now demonstrable by modern imaging techniques. These images have shown that epileptic seizures can be caused by cortical and subcortical lesions and by their accompanying oedema. We extend the review to non-epileptic paroxysmal symptoms, such as tonic spasm, which may be confused with epileptic seizures. As far as they are supported by data, recommendations for diagnosis and therapy are given. Open questions are identified and issues for further research are suggested.

Extensive cortical inflammation is associated with epilepsy in multiple sclerosis

“…With a mean prevalence value of 2.3 % (range 0.5-10 %) [1][2][3][4], epilepsy is three to six times more frequent in MS than in the general population (0.4 to 0.8 %) [5]. Moreover, MS may present with epilepsy [6,7] and, in some cases, seizures may be the only manifestation of a MS relapse [8].Whether the two diseases occur accidentally,or MS non-specifically triggers a latent proneness to epilepsy, or MS is the actual causation of seizures is still debated [9].…”

Pseudotumoral Form of Multiple Sclerosis With Symptomatic Convulsive Seizures (A Clinical Case)

“…Возникновение эпилептических приступов связы-вают как с поражением коры головного мозга, так и с лабильностью церебральных регуляторных меха-низмов, сопровождающих обострения РС [19,20]. При этом возникающие пароксизмальные эпизоды могут быть проявлением как острых симптоматичес-ких приступов (ОСП), связанных с текущим иммун-ным повреждением, так и симптоматической эпилеп-сии [8].…”

Epilepsy and Autoimmunity

“…Only 3 of 10 patients had seizures as an early symptom, and one patient had seizures after a relapse. [13] Epilepsi 2013;19(2): [39][40][41][42][43][44][45][46][47] Recently, glycine receptor alpha 1 antibodies have been described in adult and pediatric cases with progressive encephalomyelitis with rigidity and myoclonus. The clinical picture associated with glycine receptor alpha 1 antibodies is wider than the classical view of progressive encephalomyelitis with rigidity and myoclonus.…”

“…Among the partial seizures, simple partial seizures are about twice as common as complex partial seizures in MS, whereas in the general population, complex partial seizures occur more frequently than simple partial seizures. [42][43][44] Seizures are seen in patients with lesions that border the gray-white matter junction, and these lesions may exhibit gadolinium enhancement on MRI. EEG studies performed in MS patients often exhibit focal slowing, spikes, and sharp waves, but can also be normal.…”