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It’s estimated that about three out of every 100 MS patients experience seizures as a symptom of the disease, and it is more often linked to relapsing-remitting multiple sclerosis and secondary progressive MS.

While it’s difficult to consider some of the worst symptoms of multiple sclerosis, refusing to recognize them could lead to extensive damage to the body and, depending on the severity of the symptom, sometimes even death. Though most symptoms, even those that are progressive, are manageable with proper treatment, therapy, and activities, some are still terrifying.

Seizures in multiple sclerosis patients are not as common as some other symptoms but do occur, and sometimes with great voracity. Studies have shown a direct link between seizures and multiple sclerosis, leading to further research regarding ways to protect patients during a seizure and how to prevent them. In the meantime, patients need to learn how to manage seizures in multiple sclerosis to avoid serious complications.

 

How multiple sclerosis works

Patients with multiple sclerosis have developed an autoimmune condition in which the immune system attacks the central nervous system, destroying the protective coating of myelin on the nerves and nervous fibers, a coating that also helps speed electrical impulses through the nervous system. The disease is incurable and degenerative, with nerves being damaged or wasting away based on improper nervous system function or direct damage from missing myelin (demyelination).

Damage is irreversible, and as the disease progresses, many patients develop disabilities. Symptoms of the disease are physical, emotional, and cognitive, the severity of each dependent on the individual case. Each patient presents with MS uniquely, making it even more difficult to achieve successful treatment for all patients.

How MS leads to seizures

Studies with mice have shown that the lack of myelin leaves axons – the nerve cell fibers that look like threads and that pass the electrical impulses from one cell to the next – unprotected, and they form something called blebs, which are like tiny balls that keep proteins and electrical impulses from processing properly.

In addition, some interneurons are at a higher risk of damage and death, and these particular neurons are crucial in dampening any hyperactivity in the nervous system and brain. It’s believed that this is part of the reason that seizures are much more common in MS patients than in the average person — up to six times more likely, in fact.

In order to try to combat this issue, researchers are currently exploring the possibility of reducing seizures through remyelination, though results in the clinic mouse models are still in early stages and inconclusive. That means it’s important for patients to understand the types of seizures they could have and how to manage them.

Types of seizures in MS

Some types of seizures are more serious than others. The most common type of seizures in multiple sclerosis patients are partial seizures, also known as focal or localized seizures. These seizures affect only one half of the brain at a time. Sometimes, these seizures are so mild a patient won’t even realize they are having one. Partial seizures are classified into two types.

  • Simple partial seizures. A patient won’t lose consciousness during this type of seizure. Rather, everything seems a bit off or out of sorts. There may be changes to vision, hearing, odors, tastes, the way things feel, and even emotions, all seeming to come out of nowhere. It’s also possible for muscles on one side of the body or face to stiffen or even start twitching.
  • Complex partial seizures. While patients still won’t pass out, they will have a small gap in awareness, sometimes referred to as “blanking out”. The patient may stare into space, be unresponsive, repeat gestures (gulping, rubbing hands together, etc.), and seem oblivious to their surroundings, with no knowledge of what is happening until after the seizure ends.

Tonic-clonic seizures are much more serious. Also called grand mal seizures, these result in unconsciousness and a series of events.

  1. The patient will usually (but not always) experience an aura, or some sort of sensory sign that warns of the impending seizure. This could be in the form of a sensation like being in a dream, a smell or taste that comes on suddenly, or sudden and rapidly growing anxiety.
  2. The patient will lose consciousness and become rigid (the tonic phase of the seizure), typically falling hard if standing, which can lead to serious injury.
  3. It could be almost immediate or take time, but the stiffness will be followed by convulsions (the clonic phase of the seizure). The overall seizure often lasts between one and three minutes.

It’s important to remember that patients usually don’t feel any of this; however, after the seizure passes, checking for injuries is crucial to recovery. This type of seizure often results in exhaustion and disorientation. Because people do bite their tongues in these episodes, checking the tongue or inserting something to avoid injury during the seizure can help.

Managing seizures in patients with MS

Preparing for attacks is the only real tool for managing seizures in MS patients. For the most part, the patient doesn’t suffer any permanent damage from a seizure, and the issue resolves itself. However, if seizures are frequent or progressive, the managing physician may need to run additional testing in order to determine if the patient has developed epilepsy, which is about ten times more common in MS patients than in the general population. If this is the case, there are medications and therapies that can be applied in order to help resolve some of the seizures related to this additional condition.

Conclusion

It’s estimated that about three out of every hundred MS patients experience seizures as a symptom of the disease, and it is more often linked to relapsing-remitting multiple sclerosis and secondary progressive MS, especially in patients who receive the diagnosis at a younger age. The link between the two is clear, and the potential cause of seizures has been identified. However, there is more research to be done before determining of reparations to the damaged myelin could help reduce the signs and symptoms of seizures in MS patients. For now, learning about the disease and the conditions surrounding seizures in order to prepare for an attack, and knowing the protocol when a seizure occurs, are the best way to manage them.

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