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目的 :探讨多发性硬化 (Multiple sclerosis,MS)患者继发癫的临床特征及其可能的发生机制。方法 :对我院 1998～2 0 0 3年 2 2 7例 MS住院患者临床资料、脑电图 (electroencephalography,EEG)、头颅 MRI及脑脊液 (CSF)检查结果进行分析。结果 :16例 (7.0 5 % )继发癫发作 ,发作类型以全身强直阵挛发作多见 ,尚有单纯部分性运动发作、复杂部分性运动发作、视觉性作发 ,发作性语言障碍等。1例出现全身性痉挛性癫持续状态。在癫活动期 ,所有患者脑电图均有轻到中度异常 (各联波率普遍减慢 ) ,部分出现局灶性单个尖波、棘波、尖 -慢复合波、棘 -慢复合波等样放电。 MRI提示中枢神经系统内多个病灶 ,部分患者 CSF Ig G指数升高或寡克隆区带阳性。结论 :MS患者癫发生率较高 ,可能与中枢神经系统脱髓鞘病变及其伴随的免疫反应有关 ,临床上应予以重视
Objective: To investigate the clinical features and possible mechanism of secondary epilepsy in patients with multiple sclerosis (MS). Methods: The clinical data, electroencephalography (EEG), cranial MRI and cerebrospinal fluid (CSF) examination results of 227 inpatients from 1998 to 2003 in our hospital were analyzed. Results: 16 cases (7.05%) had epileptic seizures. The type of seizure was more common in patients with generalized tonic clonic seizures. There were simple partial seizures, complex partial seizures, visual hair loss and paroxysmal language disorders . One case had generalized spastic seizures. During the epileptic activity, all patients had mild to moderate abnormality of EEG (general slowdown of each wave), some of them showed focal single spikes, spikes, sharp-slow complexes, spine-slow complexes Waves and other like discharge. MRI prompts multiple lesions in the central nervous system, some patients with elevated CSF Ig G index or oligoclonal band positive. Conclusion: The high incidence of epilepsy in MS patients may be related to central nervous system demyelinating disease and its accompanying immune response, which should be paid more attention in clinic