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[Partial non-convulsive status epilepsy in multiple sclerosis].

F Maingueneau1, J Honnorat, J Isnard

  • 1Service de neurologie B, hôpital neurologique, Lyon, France.

Neurophysiologie Clinique = Clinical Neurophysiology
|February 16, 2000
PubMed
Summary
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Sudden neurological or psychiatric changes in multiple sclerosis patients may indicate epilepsy. Prompt diagnosis and treatment with antiepileptic drugs and steroids can lead to recovery.

Area of Science:

  • Neurology
  • Epileptology

Background:

  • Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system.
  • MS can present with diverse neurological and psychiatric symptoms.

Observation:

  • Two patients with MS experienced sudden neurological impairment mimicking non-convulsive partial status epilepticus.
  • Case 1: Paroxysmal dysphasia and hemiparesis with EEG showing periodic lateralized epileptiform discharges (PLEDs).
  • Case 2: Acute psychiatric symptoms including disorientation, mania, and mutism with EEG showing continuous slow wave and spike wave activity.

Findings:

  • Epileptiform activity, including PLEDs, can manifest in MS patients presenting with acute neurological or psychiatric disturbances.
  • Antiepileptic drug (AED) treatment showed partial efficacy, with intravenous steroids required for complete recovery in one case.

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  • Prompt diagnosis and initiation of AEDs are crucial for managing these acute episodes.

    • Implications:

    • Epilepsy should be considered in the differential diagnosis of acute neurological or psychiatric events in MS patients.
    • Early diagnosis and treatment of seizures can prevent prolonged disability.
    • Intravenous steroids may be a valuable adjunct therapy for refractory seizures in this population.