Seizures And Multiple Sclerosis

Many seizure types can occur in MS:

• Focal or partial seizures (those that arise from one area or focus of the brain)
• Focal seizures that generalize to both sides of the brain and cause loss of consciousness
• Seizures that are generalized from the start

About 60% of people with MS have focal aware, focal impaired consciousness, and focal to bilateral tonic-clonic (secondarily generalized) seizures.

Approximately 30-40% of people have symptomatic seizures during an MS flare-up that can sometimes become status epilepticus. In these cases, long-term epilepsy therapy is not needed. The seizure activity is related to the MS flare-up and the seizures stop when the flare-up ends.

Movements that Look Like Seizures

Not all involuntary movement is a seizure and this is especially true in MS. These seizure mimics are called non-epileptic seizure-like activity and can be just as debilitating as real seizures, since the person does not have control over these sudden bodily movements.

People living with MS may unfortunately be used to having sudden, transient symptoms occur to them as a result of their MS. Examples include:

• Uhtoff’s phenomenon: elevated body temperature causing recurrence of old MS symptoms, such as blurry vision
• Trigeminal neuralgia: sudden attacks of severe nerve pain in the face
• Lhermitte’s sign: the sensation of a painful electrical shock traveling down the spine when the neck is bent forward

Non-epileptic seizure-like activity also occurs suddenly and involuntary, just like these other symptoms.

Examples of non-epileptic seizure-like activity can include:

• Tonic spasms: sudden increased tone in the muscle that can result from MS lesions in the motor tracts of the central nervous system. This may cause sustained muscle contraction, like one arm involuntarily becoming outstretched and stiff for a short period of time.
• Choreathetosis: involuntary dance-like movements of the limbs as a result of MS lesions affecting a certain area deep in the brain called the caudate.
• Lesions in the basal ganglia can also lead to tremors, which may appear like seizures to some people given their repetitive and rhythmic nature.
• In some cases, a high number of MS lesions in the brain in general may cause difficulty paying attention and concentrating on a task or conversation. This can mimic a certain type of seizure called an absence seizure, wherein an individual loses awareness briefly and appears to stare off for several seconds.

These types of paroxysmal (sudden or intense), involuntary actions can appear like seizures and be very disturbing both physically (interrupting a person’s day-to-day activities and tasks) and mentally or emotionally (feeling like one does not have control over one’s body after already being affected by such a burdensome disease like MS). Therefore, seeing a neurologist who can accurately discern both MS and seizure-like symptoms is especially important for people living with MS.