MS: no increased risk for epilepsy after single seizure



Risk for epilepsy after a single seizure did not differ significantly between individuals with and without multiple sclerosis (MS).
Why this matters

Risk for epilepsy is elevated in patients with MS.
Recommendations allow epilepsy diagnosis after single unprovoked seizure if 10-year recurrence risk is >60%.
Risk may influence decision to initiate antiepileptic drugs.
Key results

10-year risk for epilepsy was not significantly higher for individuals with vs without MS (51.4% vs 41.3%; P=.24).
Findings were similar after excluding those presenting with status epilepticus (49.1% vs 41.2%; P=.57).
Risk vs individuals without MS was not significantly higher for individuals with relapsing-remitting MS (46.1%; P=.13) or secondary progressive MS (60.7%; P=.66).
However, the 18 individuals with MS presenting with status epilepticus had a 10-year epilepsy risk of 85.9%.
Study design

Swedish population-based cohort study of 289 individuals with MS and 222 age- and sex-matched individuals without MS who had a first diagnostic code for seizure or status epilepticus, without prior epilepsy or presumed etiology.
Main outcome: 10-year risk for epilepsy.
Funding: Swedish Society for Medicine; Magnus Bergvall Foundation; Jeansson Foundation; Göteborg Foundation for Neurological Research; institutional.

Reliance on diagnostic codes.
Residual confounding.
Some individuals with MS possibly started on antiepileptic drugs.


Source: www.univadis.co.uk