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Epileptic seizures in patients with multiple sclerosis. Is the prognosis of epilepsy underestimated?
1Institute of Neurology, University of Bergen, University Hospital, Norway.
Abstract:
The exact prevalence of epileptic seizures in patients with multiple sclerosis (MS) is still a matter of some controversy. In a population-based, unselected group of 423 patients with MS we identified 17 (4.02%) with epileptic seizures. The mean age at onset of MS was 25.2 years and at onset of epilepsy 32.6 years. A prevalence of 'active epilepsy', i.e. seizures within the last 5 years, was estimated to 3.2%. The prevalence of epilepsy in our MS population is much higher than should be expected when compared to lifetime prevalence of epilepsy in corresponding age groups. The occurrence of convulsive status epilepticus is also higher than expected, and suggests a rather serious prognosis. Thus, drug treatment should be considered after the first epileptic seizure.
Insights
Epileptic seizures affect 4.02% of multiple sclerosis (MS) patients, a higher prevalence than expected. Active epilepsy was found in 3.2%, indicating a need for early drug treatment consideration after the first seizure.
Area of Science:
- Neurology
- Epileptology
- Neuroimmunology
Background:
- The prevalence of epileptic seizures in multiple sclerosis (MS) patients remains debated.
- Understanding epilepsy occurrence in MS is crucial for patient management and prognosis.
Purpose of the Study:
- To determine the prevalence of epileptic seizures in a population-based cohort of multiple sclerosis patients.
- To compare epilepsy prevalence in MS to the general population and assess implications for treatment.
Main Methods:
- A population-based study of 423 unselected multiple sclerosis patients.
- Identification and characterization of patients experiencing epileptic seizures.
- Calculation of prevalence for overall epilepsy and 'active epilepsy' (seizures within the last 5 years).
Main Results:
- Epileptic seizures were identified in 17 patients (4.02%) with multiple sclerosis.
- The mean age of MS onset was 25.2 years, and epilepsy onset was 32.6 years.
- Active epilepsy prevalence was estimated at 3.2%, with a higher-than-expected incidence of convulsive status epilepticus.
Conclusions:
- The prevalence of epilepsy in multiple sclerosis is significantly higher than in the general population.
- The increased occurrence of status epilepticus suggests a more severe prognosis for epilepsy in MS.
- Early consideration of drug treatment after the first epileptic seizure in MS patients is recommended.