Multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) may be associated with acute symptomatic seizures and chronic epilepsy as well. The clinical features of the seizures and/or accompanying epilepsy seen in each disease group may vary. In this study, we aimed to contribute to the existing literature by describing the clinical features of seizures and epilepsy in our demyelinating patient population. We retrospectively analyzed patients who were followed up in our tertiary referral center neurology demyelinating diseases outpatient clinic between 2019 and 2024. Patients who had at least one seizure before, simultaneously, or after the diagnosis of demyelinating disease were included in the study. Among 1735 patients with MS, 40 had experienced at least one epileptic seizure (2.3 %). Thirty patients (1.7 %) had seizures that could not be explained by another factor than MS. When secondary progressive MS (SPMS) and relapsing-remitting MS (RRMS) were compared, the interval between MS-epilepsy diagnosis was longer and seizure recurrence was more in SPMS. However, the prognosis of epilepsy was good in both subtypes. There were 21 patients followed up with antibody-positive neuromyelitis optica spectrum disorder. No patient had a seizure during the follow-up. We identified 56 patients who fulfilled the criteria for MOGAD with high antibody titers. Seizures were observed in three of them (5.4 %). All of them had status epilepticus either at the onset or during the course of the disease. Even rare, seizures constitute one of the important clinical features of the inflammatory demyelinating disorders of the central nervous system. The pathophysiologic mechanism underlying seizures in MS is still not clear. Seizures may occur through different mechanisms in patients where seizures are the initial symptom or a sign of relapse and those that occur spontaneously during the progressive course of the disease. Prevalence of status epilepticus was common in MOGAD patients. Given the rarity of the seizures in CNS demyelinating disorders, it is difficult the define clinical and pathophysiological characteristics of accompanying seizures and epilepsy. Future studies conducted on large patient groups will contribute to the existing literature.

中文翻译：

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中枢神经系统炎症性脱髓鞘疾病的癫痫发作

多发性硬化症 (MS)、视神经脊髓炎谱系障碍 (NMOSD) 和髓磷脂少突胶质细胞糖蛋白抗体相关疾病 (MOGAD) 也可能与急性症状性癫痫发作和慢性癫痫有关。每个疾病组中出现的癫痫发作和/或伴随癫痫的临床特征可能有所不同。在这项研究中，我们旨在通过描述脱髓鞘患者群体中癫痫发作和癫痫的临床特征来为现有文献做出贡献。我们回顾性分析了2019年至2024年间在我们三级转诊中心神经内科脱髓鞘疾病门诊随访的患者。在脱髓鞘疾病诊断之前、同时或之后至少发生过一次癫痫发作的患者纳入研究。在 1735 名 MS 患者中，40 名患者至少经历过一次癫痫发作（2.3%）。30 名患者 (1.7%) 的癫痫发作无法用 MS 以外的其他因素来解释。当比较继发进展型 MS (SPMS) 和复发缓解型 MS (RRMS) 时，SPMS 中 MS-癫痫诊断之间的间隔较长，癫痫发作复发较多。然而，两种亚型的癫痫预后均良好。随访中有 21 名抗体阳性视神经脊髓炎谱系障碍患者。随访期间没有患者出现癫痫发作。我们确定了 56 名符合 MOGAD 标准且抗体滴度较高的患者。其中 3 人 (5.4%) 出现癫痫发作。他们都在发病时或病程中患有癫痫持续状态。即使很少见，癫痫发作也是中枢神经系统炎症性脱髓鞘疾病的重要临床特征之一。MS 癫痫发作的病理生理机制仍不清楚。患者的癫痫发作可能通过不同的机制发生，其中癫痫发作是首发症状或复发的迹象，而癫痫发作是在疾病进展过程中自发发生的。MOGAD 患者癫痫持续状态的患病率很常见。鉴于中枢神经系统脱髓鞘疾病中癫痫发作的罕见性，很难定义伴随癫痫发作和癫痫的临床和病理生理学特征。未来对大型患者群体进行的研究将为现有文献做出贡献。