Abstract Details

Title Epilepsy Monitoring Unit (EMU) Evaluations of Patients with Multiple Sclerosis (MS)

Topic MS and Related Diseases

Presentation(s) P03 - (-)

Poster/Presentation
Number 219

Objective

Background 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 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 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 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.

Authors/Disclosures
Jeffrey Kim, MD (Lundquist Neuroscience Institute) PRESENTER	No disclosure on file
Alex D. Rae-Grant, MD, FRCPC, FAAN (Ebsco Information Services)	Dr. Rae-Grant has received publishing royalties from a publication relating to health care. Dr. Rae-Grant has received publishing royalties from a publication relating to health care.
Adham Jammoul, MD (Cleveland Clinic - Hillcrest Hospital)	No disclosure on file
Christopher R. Newey, DO (Sanford Health)	Dr. Newey has nothing to disclose.
Peter A. Calabresi, MD, FAAN (Johns Hopkins University)	Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Idorsia. An immediate family member of Dr. Calabresi has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MyMD. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Myelin Repair Foundation. The institution of Dr. Calabresi has received research support from Genentech. Dr. Calabresi has received publishing royalties from a publication relating to health care. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Grant reveiwer with Myelin Repair Foundation. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME with NYAS. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Academic CME.

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