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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。
Objective: To investigate the clinical features of patients with multiple sclerosis (MS) with epilepsy and the correlation between MRI features and lesions. Methods: The clinical features and MRI findings of 10 cases (8.29%) with epilepsy who were diagnosed as MS inpatients were analyzed retrospectively. Results: Epilepsy occurred in 2 cases before other symptoms or signs of MS. Epileptic onset was the only symptom of MS in 1 case. In epileptic seizures, 7 cases had other symptoms or signs of MS. The skull MRI images of 10 patients showed deep white matter in the bilateral hemispheres and several plaques beside the lateral ventricle. Among them, 5 had cortical-subcortical plaque lesions and 2 had focal atrophy. Five cases of epileptic seizures were associated with cortical-subcortical plaque lesions. CONCLUSIONS: Epilepsy may be the first symptom of MS or the only clinical manifestation of relapse. Epileptic seizures in MS patients are associated with focal-subcortical plaque lesions.