Seizures and multiple sclerosis in Chinese patients: a clinical and magnetic resonance imaging study

Epileptic seizures in Chinese patients with multiple sclerosis (MS) have not been studied extensively. We investigated the clinical, laboratory, and imaging findings for Chinese patients with MS who had experienced seizures.

A total of 93 (57.4%) patients were diagnosed as having conventional MS and 69 (42.6%) patients as having neuromyelitis optica (NMO) over 20 years. Data on clinical symptoms, related examinations, and treatment were analyzed retrospectively.

Eight patients (8.6%), all of whom were female, had seizures during the course of relapsing-remitting MS. One had seizures as the presenting symptom of MS. The seizure type was focal onset in all the 8 patients, 6 of whom had secondarily generalized seizures. Only 1 patient was recorded as having focal epileptiform discharges by electroencephalography. The frequency of seizures was significantly higher in patients with recurrent seizures than in those with acute-MS-related seizures. Diffuse or extensive lesions were observed in acute-MS-related seizures; focal persistent lesions were related to recurrent seizures or even status epilepticus, both of which need long-term antiepileptic medication.

The seizure courses (acute or recurrent) and distribution of lesions (diffuse or localized) might provide information on seizure recurrence and decide antiepileptic treatment strategies.