Research: MS brain lesions and epilepsy

#MSBlog: Seizures in MS; do you know about them?

Martínez-Lapiscina et al. Cortico-juxtacortical involvement increases risk of epileptic seizures in multiple sclerosis. Acta Neurol Scand. 2013 Jan 7. doi: 10.1111/ane.12064.

OBJECTIVES: Previous studies have reported an increased risk for epileptic seizures in MSers. However, data on the pathogenesis of seizures remain inconclusive. The aim of this study is to evaluate prevalence, clinical and paraclinical features of epileptic attacks in an MS cohort and to search MS-specific risk factors for epileptic seizures.

MATERIALS AND METHODS: In this cohort of 428 MSers, 13 MSers were identified with epileptic seizures occurring at any point during the course of MS including at MS onset. As a control group, they selected 26 MSers without seizures and matched them for gender, age and date of MS onset. They compared demographic features and clinic-radiological findings between the groups.

RESULTS: Thirteen MSers (3%) were identified as having epileptic attacks. Ten MSers (77%) experienced focal seizures, half of whom had confirmed secondary generalization (major seizures with loss of conciousness). They did not find an association between seizures and disease course. Most MSers had a single or few (2-5) seizures. MSers with seizures had a significantly higher number of cortical and juxtacortical lesions on T2-weighted/fluid attenuation inversion recovery magnetic resonance imaging than control group [OR = 2.6 CI95% (1.0-6.5); P = 0.047].

CONCLUSIONS: These findings support a credible role of cortical and juxtacortical involvement in the development of epileptic seizures in MS.

“This study confirms what we have always suspected that seizures in MS are due to gray matter involvement.”

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