(AAN) Epilepsy monitoring unit evaluations of PwMS

 
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PostPosted: Fri Mar 29, 2013 6:15 pm    Post subject: (AAN) Epilepsy monitoring unit evaluations of PwMS Reply with quote

Presented at the AAN conference in San Diego, March 16-23, 2013:

Quote:
[P03.219] Epilepsy Monitoring Unit (EMU) Evaluations of Patients with Multiple Sclerosis (MS)

Jeffrey Kim, Cleveland, OH, Alexander Rae-Grant, Cleveland, OH, Adham Jammoul, Cleveland, OH, Christopher Newey, Garfield Heights, OH

OBJECTIVE:

We reviewed the seizure semiology, electroencephalography (EEG) and MRI findings of patients with multiple sclerosis (MS) who were evaluated in an epilepsy monitoring unit (EMU).

BACKGROUND:

Epileptic seizures occur more frequently in patients with MS as compared to the general population. One possible mechanism for epilepsy in MS patients is cortical demyelinating lesions serving as foci for seizure activity.

DESIGN/METHODS:

We retrospectively evaluated charts of patients with MS who were seen in the EMU over a 5-year period. We reviewed the records of 21 patients, including their electroencephalography and MRI imaging results.

RESULTS:

The average length of stay in the EMU was 4.5 days. Six patients had an ictal EEG pattern while monitored, with five (or 83.3%) of these patients having focal seizures. Three patients had complex partial seizures, and two patients had complex partial seizures with secondary generalization. One patient had a generalized ictal EEG pattern with myoclonic seizures, and was diagnosed with juvenile myoclonic epilepsy.

MRI imaging of the brain was available for review for five of the six patients with seizures, of which four had cortical demyelinating lesions. Of the fifteen patients who did not have an ictal EEG pattern, all had normal interictal EEG with exception of one patient with epileptiform interictal findings (regional spike and wave complexes), and one patient with non-epileptiform interictal findings (generalized slowing). Seven of the fifteen patients experienced their typical events while under monitoring. Of these seven patients, six of them were felt to be having non-epileptic seizures.

CONCLUSIONS:

Our EEG and MRI findings are consistent with a mechanism of cortical lesions in MS providing an epileptogenic focus. A larger study looking at the MRI characteristics of patients with both MS and epilepsy may help to clarify the potential mechanisms of epilepsy in MS patients.


Category - MS and Related Diseases: Clinical Science

Tuesday, March 19, 2013 2:00 PM

Session P03: Multiple Sclerosis: Quality of Life and MS Symptoms
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