Rabia Gökçen GÖZÜBATIK ÇELİK, Mesrure KÖSEOĞLU

Multipl Sklerozda Epileptik Nöbetler

Amaç: Epilepsi nöbeti Multipl Skleroz’un (MS) nadir bir prezentasyonudur. Bu çalışmada nöbetlerin MS’in seyri ile olan ilişkilerini, rekürren nöbetleri tetikleyebilecek faktörleri, status epileptikus prevelansını ve buna bağlı olarak epilepsi tedavisini başlama yada sürdürmedeki öngörümüzün oluşmasını amaçladık.Yöntem: MS tanılı 995 hastadan epilepsi nöbeti geçiren 56’sı çalışmaya dahil edildi.Hastaların sosyodemografik verileri, hastalık süresi, MS atak sıklığı, nöbet sıklığı, elektroensefalografi bulguları, EDSS skorları Microsoft Office Excel'e kaydedildi.Bulgular: Hastaların çoğu [%68’i (n:38)] kadındı. Ortalama yaş 28±10,5yıldı (min-max:18-61yıl). MS’in ilk atağı nöbet olan hasta 5 (%9) kişi idi. MS tipi ile nöbet varlığı açısından bir fark izlenmedi (p>0,05). Nöbet tipleri ile ortalama EDSS skoru ve MS atak sıklığı açısından karşılaştırıldığında anlamlı bir sonuca varılmadı (p>0,05). 56 hastanın %63’inde (n:35) rekürren nöbetler izlendi. 21 kişi ise 4 yıl boyunca tekrar nöbeti olmadı. Rekürren nöbet açısından CIS/RRMS olma ve ailede epilepsi öyküsü rekürren nöbetler için risk faktörleriydi (p<0,05). Rekürren nöbeti olanların 14 (%40)’ü interferon veya azatiopürin tedavileri; tek nöbeti olanların 8’i (%38) diğer oral MS-tedavilerini kullanmakta olup tedavi ve rekürren nöbet arasında anlamlı bir ilişki izlenmedi (p=0,301).Sonuç: Rekürren nöbet için risk fakörlerini taşıyan MS hastalarının uygun antiepileptik tedaviye başlanarak takiplerinin yapılması önemlidir.

Anahtar Kelimeler:

Epilepsi, multipl skleroz, rekürren nöbet, risk faktörleri

Multiple Sclerosis and Epilepsy

Objective: Seizure is a rare presentation of Multiple Sclerosis (MS) patients. We aimed to establish the relationship between seizures and the course of MS, the factors that may trigger recurrent seizures, the prevalence of status epilepticus, and accordingly, our prediction to start or continue epilepsy treatment.Methods: Fifty-six of 995 MS patients who had epileptic seizures were included. Sociodemographic data, disease duration, MS attack frequency, seizure frequency, electroencephalography, EDSS scores were recorded in Microsoft Office Excel.Results: Most of the patients [68% (n:38)] were women. The mean age was 28 ± 10.5 years (min-max: 18-61 years). In 5 patients (9%), seizure had a first MS attack. There was no difference between MS type and seizure (p>0.05). No significant result was obtained when the types of seizures were compared in terms of mean EDSS score and MS attack frequency (p>0.05). Recurrent seizures were observed in 63% (n: 35) of 56 patients. 21 people did not have seizures again for 4 years. In terms of recurrent seizures, being CIS / RRMS and family history of epilepsy were risk factors for recurrent seizures (p<0.05). 14 (40%) using interferon or azathioprine in those with recurrent seizures; 8 of them (38%) were using other oral-MS-therapy only, and no significant relationship was observed between treatment and recurrent seizures (p=0.301).Conclusion: It is important to follow-up with appropriate antiepileptic treatment of MS patients who carry risk factors for recurrent seizures. Epilepsy has no role in MS prognosis.

Keywords:

Epilepsy, multiple sclerosis, recurrent seizure, risk factors,

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