Cortico-juxtacortical involvement increases risk of epileptic seizures in multiple sclerosis
Cortico-juxtacortical involvement increases risk of epileptic seizures in multiple sclerosis
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DOI：
10.1111/ane.12064
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发表时间：
2013-07-01
影响因子：
3.5
通讯作者：
Bacaicoa, M. C.
中科院分区：
文献类型：
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作者：
Martinez-Lapiscina, E. H.;Ayuso, T.;Bacaicoa, M. C.
目的以往的研究报道多发性硬化（MS）患者癫痫发作的风险增加。然而，癫痫发作的发病机制的数据仍然没有定论。本研究的目的是评估多发性硬化患者癫痫发作的患病率、临床和临床旁特征，并寻找多发性硬化患者癫痫发作的特异性危险因素。材料与方法在428例MS患者中，13例患者被确定为癫痫发作发生在MS过程中的任何时间点，包括在MS发作。作为对照组，我们选择了26例没有癫痫发作的MS患者，并在性别、年龄和MS发作日期方面进行了匹配。我们比较了两组的人口统计学特征和临床放射学结果。结果13例（3%）患者被确定为癫痫发作。10名患者（77%）出现局灶性癫痫发作，其中一半已证实继发性全身性发作。我们没有发现癫痫发作和疾病过程之间的关联。大多数患者有单一或少数（2-5）癫痫发作。MS发作患者在T2加权/液体衰减反转恢复磁共振成像上的皮质和前皮质病变数量显著高于对照组[OR=2.6 CI95%（1.0-6.5）; P=0.047]。结论：我们的研究结果支持了MS患者癫痫发作的发展过程中皮质和副皮质参与的可信作用。
Objectives Previous studies have reported an increased risk for epileptic seizures in multiple sclerosis (MS) patients. However, data on the pathogenesis of seizures remain inconclusive. The aim of our study is to evaluate prevalence, clinical and paraclinical features of epileptic attacks in our MS cohort and to search MS-specific risk factors for epileptic seizures. Materials and methods In this cohort of 428 MS patients, 13 patients were identified with epileptic seizures occurring at any point during the course of MS including at MS onset. As a control group, we selected 26 MS patients without seizures and matched for gender, age and date of MS onset. We compared demographic features and clinic-radiological findings between the both groups. Results Thirteen patients (3%) were identified as having epileptic attacks. Ten patients (77%) experienced focal seizures, half of whom had confirmed secondary generalization. We did not find an association between seizures and disease course. Most patients had a single or few (2-5) seizures. MS patients 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 Our findings support a credible role of cortical and juxtacortical involvement in the development of epileptic seizures in MS.