10例多发性硬化伴癫癎发作与MRI相关性分析

Correlation Between the Seizures and MRI Findings in 10 Seizuric Patients with Multiple Sclerosis

目的:探讨多发性硬化(MS)伴癫癎发作患者的临床特点与MRI所示病灶的相关性。方法:回顾性分析121例确诊为MS住院患者中10例(8.29%)伴癫癎发作的临床特点及MRI表现。结果:癫癎在MS其他症状或体征之前出现2例;癫癎发作为MS复发时唯一症状的1例;癫癎发作时已伴MS其他症状或体征者7例。10例患者头颅MRI均示双侧半球的深部白质、侧脑室旁数个斑块病灶,其中5例伴皮质-皮质下斑块病灶,2例伴局灶性皮质萎缩。5例癫发作与皮质-皮质下斑块病灶有相关性。结论:癫癎可以是MS的首发症状或复发时唯一临床表现,MS患者癫癎发作与皮质-皮质下斑块病灶相关。

Aim： To investigate the clinical correlation between the seizures and MRI findings in patients with seizures and multiple sclerosis （ MS ）. Methods： The clinical and brain MRI features of 10 cases （8.29%） with epilepsy in 121 patients with definite MS hospitalized were analyzed retrospectively. Results： In 2 cases, epilepsy occurred firstly before other clinical manifestation of MS. In 1 case, seizures were the only manifestation of relapse. In the other 7 cases, seizures were partial with secondary generalization. Brain MRI disclosed all 10 cases who had numerous deep white matter and periventricular plaques in both hemispheres. Among them, 5 cases had cortical-subcortical lesions and 2 cases had focal cortical atrophy. Cortical-subcortical lesions and seizure type correlation existed in 5 cases. Conclusion： Epilepsy may represent an initial symptom of MS and a single clinical manifestation of a relapse, there is acorrelation between the cortical-subcortical lesions and epileptic seizures in patients with MS.