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Clinical characteristics, course and prognosis of Multiple Sclerosis patients with epilepsy. A case control study: MS and epilepsy

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dc.contributor.author Sánchez, M.
dc.contributor.author Marone, Abril
dc.contributor.author Silva, Walter H.
dc.contributor.author Marrodán, Mariano
dc.contributor.author Correale, Jorge
dc.date.accessioned 2024-01-29T13:41:02Z
dc.date.available 2024-01-29T13:41:02Z
dc.date.issued 2024-01-02
dc.identifier.citation Sánchez M, Marrone A, Silva WH, Marrodán M, Correale J. Clinical characteristics, course and prognosis of Multiple Sclerosis patients with epilepsy. A case control study: MS and epilepsy. Mult Scler Relat Disord. 2024 Jan 2;83:105422. doi: 10.1016/j.msard.2024.105422. Epub ahead of print. es_ES
dc.identifier.uri https://doi.org/10.1016/j.msard.2024.105422
dc.identifier.uri https://repositorio.fleni.org.ar/xmlui/handle/123456789/962
dc.description.abstract Background and purpose: Although more common than in the general population, seizures are an atypical manifestation of multiple sclerosis (MS) and their pathophysiology is not well understood. This study aims to examine the prevalence, clinical characteristics, brain imaging findings and course of epilepsy, presenting in patients with MS. Methods: Observational retrospective study of MS patients evaluated at a single MS reference center in Buenos Aires, Argentina, between 2011 and 2022, focusing on those who developed epilepsy (EMS). Clinical, demographic, and prognostic factors were evaluated and compared to a control group of non-epileptic MS patients (NEMS). To analyze specific epilepsy characteristics, a second control group of patients with non-lesional focal epilepsy (FNLE) was also included. Results: Twenty-five patients (18 women), were diagnosed with epilepsy, corresponding to a prevalence of 1.95%. Comparison of brain imaging characteristics between EMS and NEMS patients showed brain atrophy (32% vs 6.1%, p<0.01), as well as cortical (26% vs 4%, p=0.03) and juxtacortical lesions (84% vs 55%, p=0.05), were more frequent in EMS patients. However, after multivariate analysis, cortical atrophy was the only variable linked to a significant increase in risk of epilepsy (OR 24, 95%CI=2.3-200, p<0.01). No significant differences in clinical characteristics, disease activity, disability levels, response to disease modified treatment (DMT) or lack of DMT efficacy were observed between MS patients with or without epilepsy. Most patients received anti-seizure medication (ASM), and seizure control was better in EMS than in FNLE patients (92% vs 58%, p=0.022) with no differences found in drug resistance. We did not find predictors of seizure recurrence in the population studied. Conclusion: We observed a lower prevalence of epilepsy in this group of MS patients, compared to other reported cohorts. Although epilepsy seems to have a benign course in MS patients, cortical atrophy appears to be an important contributor to the development of secondary epilepsy in MS patients. Further investigations will be necessary to identify risk factors or biomarkers predicting increased epilepsy risk in MS. es_ES
dc.language.iso eng es_ES
dc.publisher Elsevier es_ES
dc.subject Multiple Sclerosis es_ES
dc.subject Esclerosis Múltiple es_ES
dc.subject Epilepsy es_ES
dc.subject Epilepsia es_ES
dc.title Clinical characteristics, course and prognosis of Multiple Sclerosis patients with epilepsy. A case control study: MS and epilepsy es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.description.fil Fil: Sánchez, M. Fleni. Departamento de Neurología; Argentina.
dc.description.fil Fil: Marone, Abril. Fleni. Departamento de Neurología; Argentina.
dc.description.fil Fil: Silva, Walter H. Fleni. Departamento de Neurología. Centro Integral de Epilepsia y Unidad de Video EEG; Argentina.
dc.description.fil Fil: Marrodán, Mariano. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.
dc.description.fil Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.
dc.relation.ispartofVOLUME 2
dc.relation.ispartofNUMBER 83
dc.relation.ispartofPAGINATION 105422
dc.relation.ispartofCOUNTRY Países Bajos
dc.relation.ispartofCITY Ámsterdam
dc.relation.ispartofTITLE Multiple sclerosis and related disorders
dc.relation.ispartofISSN 2211-0356
dc.type.snrd info:ar-repo/semantics/artículo es_ES


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