Epileptic seizures in multiple sclerosis

Various studies have attempted to determine the incidence and prevalence of seizures in multiple sclerosis (MS), although the exact prevalence of epileptic seizures is still controversial. The aim of this study was to assess the association between MS and epilepsy, to analyze clinical findings of epilepsy in MS patients, to estimate electroencephalography (EEG) and magnetic resonance imaging findings of the central nervous system (CNS), response to antiepileptic drug treatment and possible association of the prevalence of epileptic seizures with MS severity and duration. Medical records of 224 MS patients diagnosed at Pula General Hospital during a 25-year period (1985-2010) were reviewed. Seizures apparently occurred more commonly in MS patients than in the general population. Partial seizures with or without secondary generalization appeared to be more common. Primary generalized epilepsy has also been reported, although less frequently. The onset of epileptic seizures preceded the diagnosis of MS, occurred in parallel or within five years of MS onset. The occurrence of epileptiform EEG abnormalities in MS patients was rare. The lesions involved in the pathogenesis of epilepsy were plaques or demyelination affecting cortical or subcortical areas (predominantly frontal and temporal). Generally, seizure control with standard antiepileptic drugs was good.