9. Clinical Profile of Seizures in Multiple Sclerosis Patients in a Tertiary Care Center

• Published in: Multiple sclerosis and related disorders 2024-12, Vol.92
• Main Authors: Alrushid, Eythar, Alhowaish, Thamer S., Alamri, Noof, Bensaeed, Nora Zaid, Alanazi, Ali, Abulaban, Ahmad
• Format: Article
• Language: English
• ISSN: 2211-0348
• DOI: 10.1016/j.msard.2024.105970

Seizures can occur in patients with multiple sclerosis (MS). The mechanisms underlying seizures and their impact on MS progression remain unclear. The aim of this cohort is to explore the relationship between multiple sclerosis and seizures and investigate aspects such as prevalence, manifestations, risk factors, management, and outcomes to improve our understanding of this association. A single-center retrospective cohort study that included 55 patients. All patients with a confirmed diagnosis of multiple sclerosis and had one or more seizures were included from 2016 to 2022. Data collected included patient demographics, multiple sclerosis characteristics, course of seizures or epilepsy, medications, and MRI findings. Of 1244 MS patients, 55 patients had at least one seizure, with a prevalence of 4.4%. Of the 55 MS patients with seizures, two-thirds were females, predominantly exhibiting Relapsing-Remitting MS (RRMS). In more than two-thirds (72.7%) of the patients, the seizures occurred before the age of 30. In 31 patients (56.4 %), seizures occurred more than twice. Infection was the most common risk factor for seizures (10.9%). Seizures were controlled in 31 patients (56.4%) and the majority were dependent on a single anticonvulsant; the most commonly prescribed medication was levetiracetam. Of patients diagnosed with MS under the age of 20, 54.5% experienced early-onset seizures compared to 33.3% diagnosed at age 30 or older (P=.011). In addition, 63.6% of MS patients diagnosed early had more than two seizures, compared with 40% of those diagnosed after 30 years (P=0.048). Common MRI findings included cortical atrophy, particularly in the temporal lobe. Seizures occurred in 4.4% of patients and were more common in women and young patients. RRMS MS is the predominant type. In more than half of the patients, seizures occurred more than twice. The most common risk factor for seizures was infection. In more than half of the patients, the seizure could be controlled with a single medication. The younger the patients were, the more likely they were to have an early onset of seizures and a recurrence of seizures. Common MRI findings included cortical atrophy, particularly in the temporal lobe. This study provides valuable insight into the complicated relationship between MS and seizures, taking into account demographic trends, predominant MS subtypes, clinical manifestations, therapeutic approaches, and radiologic features.