Seizures in patients with multiple sclerosis seen at Mayo Clinic, Rochester, Minn, 1990-1998
Seizures in patients with multiple sclerosis seen at Mayo Clinic, Rochester, Minn, 1990-1998
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DOI：
10.4065/76.10.983
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发表时间：
2001-10-01
影响因子：
8.9
通讯作者：
Rodriguez, M
中科院分区：
文献类型：
--
作者：
Nyquist, PA;Cascino, GD;Rodriguez, M
目的：为了评估癫痫发作类型，脑电图结果，并对抗癫痫药物（AED）治疗多发性硬化症（MS）患者和共存的seizure activity.Patients和方法：我们回顾了1990年至1998年期间在明尼苏达州罗切斯特的马约诊所诊断为MS和癫痫发作的所有患者的病历。在研究期间，确定了5715例MS患者。在这5715例患者中，51例（0.89%）出现癫痫发作活动。最常见的发作行为为全身强直阵挛性发作35例（68.6%）。11例（21.6%）患者发生简单或复杂部分性发作，18例（35.3%）患者仅发生1次发作。3例患者（5.9%）发生局灶性癫痫运动持续状态，即部分持续性癫痫，并伴有认知功能障碍。在37例患者（72.5%）中，首次癫痫发作出现在MS诊断之后。14例患者（27.4%）的癫痫发作导致MS诊断或发生在MS诊断之前，但在脱髓鞘疾病的其他症状或体征之后。对43例患者进行了脑电图检查。脑电图表现为弥漫性或局限性非特异性背景变慢19例（44.2%），单侧或双侧额颞棘波9例（20.9%），广泛性非典型棘波或多灶性独立性癫痫样改变6例（14.0%），正常11例（25.6%）。在接受AED治疗的45例患者中，35例（77.8%）有极好的反应，即无癫痫发作。五个治疗的患者（11.1%）有一个顽固性的癫痫disorder.Conclusion：大部分的MS患者经历了癫痫发作活动有一个良性的和短暂的障碍，是响应AED治疗或不需要治疗。
Objective: To evaluate seizure type, electroencephalographic findings, and response to antiepileptic drug (AED) treatment in patients with multiple sclerosis (MS) and coexistent seizure activity.Patients and Methods: We reviewed the medical records of all patients seen at the Mayo Clinic in Rochester, Minn, with the diagnosis of MS and seizures between 1990 and 1998.Results: During the study period, 5715 patients with MS were identified. Of these 5715 patients, 51 (0.89%) experienced seizure activity. The most common ictal behavior was a generalized tonic-clonic seizure in 35 patients (68.6%). Simple or complex partial seizures occurred in 11 patients (21.6%), and 18 patients (35.3%) had only 1 seizure episode. Focal motor status epilepticus, ie, epilepsia partialis continua, occurred in 3 patients (5.9%) and was associated with cognitive impairment. In 37 patients (72.5%), the initial seizure presentation was after the diagnosis of MS. A seizure resulted in the diagnosis of MS or occurred before the diagnosis of MS but after other symptoms or signs of demyelinating disease in 14 patients (27.4%). Electroencephalography was performed in 43 patients. Electroencephalographic findings included diffuse or localized nonspecific background slowing in 19 patients (44.2%), unilateral or bilateral frontotemporal spike discharges in 9 (20.9%), generalized atypical spike-and-wave or multifocal independent epileptiform alterations in 6 (14.0%), and normal results in 11 (25.6%). Of the 45 patients who received AED therapy, 35 (77.8%) had an excellent response, ie, they were seizure free. Five treated patients (11.1%) had an intractable seizure disorder.Conclusion: Most of the patients with MS who experienced seizure activity had a benign and transient disorder that was responsive to AED treatment or required no therapy.