Clinical profile of seizures among multiple sclerosis patients in a tertiary care center

Seizures can occur in patients with multiple sclerosis (MS). The mechanisms underlying seizures and their impact on MS progression remain unclear. The aim of this cohort is to explore the relationship between multiple sclerosis and seizures and investigate aspects such as prevalence, manifestations, risk factors, management, and outcomes to improve our understanding of this association.

A single-center retrospective cohort study that included 55 patients. All patients with a confirmed diagnosis of multiple sclerosis and had one or more seizures were included from 2016 to 2022. Data collected included patient demographics, multiple sclerosis characteristics, course of seizures or epilepsy, medications, and MRI findings.

Among 1244 MS patients, 55 (4.4 %) had seizures. The majority (78.2 %) were female and 61.8 % were diagnosed with RRMS. Two-thirds of seizures occurred before the age of 30, and over half (56.4 %) had more than two seizures. Infection was the most common risk factor (10.9 %). Seizures were controlled in approximately two-thirds (62.3 %) of the patients. Common MRI findings included cortical atrophy, particularly in the temporal lobe. A statistically significant association was found between younger age and the recurrence of seizures (P = 0.048).

This study offers valuable insight into the complex relationship between multiple sclerosis and seizures. It underscores the importance of considering MS in the differential diagnosis when a young patient presents with a seizure of unclear etiology. Early recognition can aid in timely diagnosis and appropriate management.