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Epileptic seizures in multiple sclerosis: a population-based survey in Iran

Abstract

No large population-based survey has until now been carried out on the linkage of epilepsy (EP) and multiple sclerosis (MS) either in the middle-east or in Asia. In this retrospective population-based study (April 2003 to July 2010) on the total Isfahan cohort of 3,522 Iranian MS patients, we looked for EP/MS patients and compared their features with 1,665 non-EP/MS cases. We identified 105 cases, though, 24 were excluded for an implausible EP/MS link. Among 81 (2.3 %) eligible cases, EP occurred (1) within a mean duration of 5.6 ± 5.4 years after the development of MS in 64 cases (79 %); (2) at MS onset as the presenting symptom in five cases (6.2 %); and, (3) by a mean duration of 4.3 ± 4.3 years prior to onset of MS in 12 patients (14.8 %). The overall mean ages at MS onset and at the first seizure episode were 28.5 ± 11.2 years and 32.5 ± 14.0 years, respectively. Regarding the age at onset of MS, 12.3 % of EP/MS patients were classified as early-onset; 81.5 % as adult-onset; and 6.2 % as late-onset. Such frequencies were statistically different (P < 0.0001) from those of the 1,665 control non-EP/MS patients (5.9; 93.0 and 1.1 %, respectively). Regarding the pattern of MS, EP/MS patients were classified as relapsing-remitting, secondary progressive, and primary progressive in 60.5, 25.9, and 13.6 %, respectively. This configuration differed (P < 0.0001) from that of non-EP patients (87.9; 6.3 and 5.7 %, respectively). Our results are suggestive of differences between EP/MS and non-EP/MS cases as regards the proportion of MS patterns and age-at-onset classifications.

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Acknowledgments

The authors are very grateful to the patients and their relatives for their collaboration with this research. This survey was conducted with the cooperation of the Iran national Ministry of Health and Medical education; Isfahan University of Medical Sciences (IUMS) and Isfahan Multiple Sclerosis Society (IMSS). Also, a specific research grant has been received from CinnaGen Inc. for implementation of the project and its data collection. The results of this study are dedicated to the memory of Dr. Afsane Khandan (Iranian internist) who devoted her precious life to knowledge, health development, and, medical research.

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The authors have no proprietary interest in the materials presented herein.

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Correspondence to Seyed-Hossein Abtahi.

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Etemadifar, M., Abtahi, SH. & Roomizadeh, P. Epileptic seizures in multiple sclerosis: a population-based survey in Iran. Acta Neurol Belg 113, 271–278 (2013). https://doi.org/10.1007/s13760-012-0146-6

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  • DOI: https://doi.org/10.1007/s13760-012-0146-6

Keywords

  • Multiple sclerosis
  • Epilepsy
  • Seizure
  • Isfahan
  • Iran