Seizures in Multiple Sclerosis

Epilepsy risk is three times higher than the general public

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As a neuromuscular disorder (a disease affecting the nerves and muscles), it may not surprise you that multiple sclerosis (MS) places a person at higher risk of seizures and epilepsy. In fact, current research suggests that as many as three percent of people living with MS have epilepsy—nearly three times the national average.

Understanding Epilepsy and Seizures

A seizure is caused by inappropriate or excessive electrical activity in the brain, usually in the cerebral cortex.

Epilepsy, by contrast, is defined as recurring seizures caused by this sort of abnormal brain activity.

While many people are frightened by the very notion of a seizure—having been weaned on disturbing images in TV dramas—they can vary significantly in their symptoms and severity. Some are transient and near-imperceptible, while others can be far more severe and unnerving.

Tonic-Clonic Seizures

Tonic-clonic seizures are considered the most serious type. They are characterized by the loss of consciousness and muscular rigidity (the tonic phase) accompanied by convulsions (the clonic phase). Sometimes referred to as grand mal seizures, they generally last for one to three minutes.

While distressing, most people who experience a tonic-clonic seizure don't actually feel them. In many cases, a person will experience a sensory warning sign prior to the seizure, known as an aura. These may include a fuzzy or dream-like sensation, a strange smell or taste, or a sudden feeling of anxiety.

After a tonic-clonic seizure, the person will typically feel exhausted, washed-out, and disoriented. Head and bodily injury can sometimes occur if the person collapses when unconsciousness And unfortunately, true to TV dramas, people can often bite their tongues or lips during the seizure. Inserting a hard object into the person's mouth is unadvised as this may only cause broken teeth or choking.

Simple or Complex Partial Seizures

Focal seizures (also called partial or localized seizures) are those that affects one hemisphere of the brain. Their appearance is less dramatic than tonic-clonic seizures and, in some cases, may be hardly noticed by the person experiencing one. These seizures are broadly classified as follows:

  • Simple partial seizures do not cause the person to lose consciousness but rather make everything seem momentarily "off." Persons often describe feeling strange emotions or experiencing changes in how things look, sound, feel, smell, or taste. In some cases, the person’s muscles may stiffen or start twitching, usually on one side of the face or body.
  • Complex partial seizures also do not cause unconsciousness but, instead, result in a sudden gap in awareness. It is as if the person "blanked out rather than passing out. During the seizure, the person may not be able to respond and will often stare into space or act in a repetitive way (such as rubbing hands, gulping, making repetitive sounds). In most cases, the person will not remember what happened after the attack is over.

Treating Seizures in People With MS

Seizures in people with MS tend to be mild and cause no permanent damage.

While the vast majority can control or entirely eliminate seizures medication, many are able to manage without treatment of any sort. When needed, there are over 30 different anticonvulsive medications used to treat epilepsy with varying side effects and contraindications.

However, it is important to note that many of the paroxysmal symptoms of MS (including spasticity, sensory distortions, and unexplained slurring) can mimic a simple partial seizure. If you're experiencing any seizure-like symptom, it is important to speak with your doctor who can refer you to a neurologist for further investigation.

Whatever the cause, antiepileptic medications can often be prescribed to lower the incidence of these and other neuromuscular symptoms.

Source:

Allen, A.; Seminog, O.; and Goldacre, M. "Association between multiple sclerosis and epilepsy: large population-based record-linkage studies." BMC Neurology. 2013; 13:189

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