1-Hadi abbasi
2-karim nikkhah
Neurology department,Mashhad university of medical
sciences
Objective:
Although the prevalence of
seizure is higher in multiple sclerosis (MS) patients compared to the general
population, there is no study to assess the epidemiology of non-epileptic
seizures in MS and differentiating this disorder from other kinds of seizures.
The aim of our study is to epidemiologically assess non-epileptic seizures in
patients of Khorasan MS society (KMS) in order to find a diagnostic pattern in
EEG and MRI to be associated with this disorder.
Methods & Materials: We searched in a sample of 812
patients from the total population of 4000 MS cases in KMS for non-epileptic
seizure cases. All the found cases were followed for 1 year and their seizure
or MS attacks were followed in this period. All the patients underwent magnetic
resonance imaging (MRI) and electroencephalography (EEG). Data regarding the
severity of the lesion in MRI and EEG were entered in SPSS software and
descriptive and analytic statistics were extracted.
Results: From a total sample of 812 patients, 13 cases
(1.6%) of MS related non-epileptic seizure were reported from them, 10 patients
(76.9%) accepted to participate in the study. All the cases experienced
generalized seizures and the MS type in 9(90%) cases except one (10%) with
primary progressive MS, was relapsing remitting MS. Totally, Background slowing
was observed in 6 cases (60%) (4 mild cases (40%) and 2 sever cases (20%)). MRI
findings showed cortical atrophy in 9 patients (90%) (one mild case (10%), 6
moderate cases (60%) and 2 sever cases(20%)), subcortical and juxtacortical
lesions in all cases (5 mild cases(50%), 3 moderate cases(30%) and 2 sever
cases(20%)) and other white matter lesions also in all cases (9 moderate
cases(90%) and 1 sever case(10%)). There was no significant difference
regarding the duration of the MS diagnosis in different severity of EEG and MRI
pathologies (p value>0.05). But there was significant difference regarding
severity of cortical atrophy in severity of EEG backgrond slowing (Pvalue<0.036)
and presence of EEG backgrond slowing in severity of subcortical and
juxtacortical lesions (Pvalue<0.015)
Conclusion: Although some pathologic findings have been
found in EEG and MRI of these patients, still we cannot propose a pathognomonic
feature for these Para clinic findings. Our study had a good sample size and
the epidemiologic findings were useful; however conducting population-based
studies is advisable due to the low number of MS cases with seizure.
keyword:
epilepsy and multiple sclerosis,
prevalence of seizure in MS Patients, analysis of EEG in MS Patients,
Electroencephalogram and MRI correlations in MS
patients
