Background: Little is known about the incidence and characteristics of acute epileptic seizures in myelin oligodendrocyte glycoprotein encephalomyelitis (MOG-EM) and neuromyelitis optica spectrum disorder (NMOSD). In this study, we compared the incidence and characteristics of acute epileptic seizures in MOG-EM and NMOSD patients.
Methods: MOG-EM (n = 61) and NMOSD (n = 565) cases obtained from the MSNMOBase (2011-2018) were retrospectively reviewed.
Results: Acute epileptic seizures were observed in 13 (21.3%) patients with MOG-EM and two (0.4%) patients with NMOSD (P < 0.001). In both MOG-EM and NMOSD patients, more than half of seizures were single and of focal onset; slow wave and cortical/subcortical lesions were the most common abnormalities. In MOG-EM patients, no difference was found in the proportion of single seizure with and without anti-epileptic drugs (AEDs; 64.3% vs. 45.5%, P = 0.435). Long-term AED use did not significantly reduce the occurrence of acute epileptic seizures, which was 66.7% before and after treatment. In patients with MOG-EM and NMOSD, mycophenolate mofetil significantly reduced acute epileptic seizure occurrence (P = 0.024).
Conclusion: Acute epileptic seizures were more common in MOG-EM patients than in NMOSD patients. The long-term use of AEDs might be unnecessary given the use of immunotherapy in cases of MOG-EM.
Keywords: Aquaporin 4; Encephalomyelitis; Epileptic seizure; Myelin oligodendrocyte glycoprotein; Neuromyelitis optica spectrum disorder; Treatment.
Copyright © 2018. Published by Elsevier B.V.