ABSTRACT

While epileptic seizures are seen in the course of multiple sclerosis, they are rarely the first symptom. The first epileptic seizure of a 26-yearold woman with multiple sclerosis is described in the present report. The patient presented to the emergency department with generalized tonic-clonic seizure. Neurologic examination was normal except for right-sided hemiparesis and hyperactive deep tendon reflexes. Cranial MRI revealed periventricular, multiple millimetric lesions and a 45x27-mm, semi-ring-enhanced, cortical, T2/FLAIR, hyperintense lesion in the centrum semiovale. IgG index was high, and oligoclonal band was positive in cerebrospinal fluid examination. Electroencephalography showed prominent fronto-temporal activity on the left side and sharp wave paroxysms. Multiple sclerosis was diagnosed, and pulse corticosteroid therapy was initiated. Due to recurrent seizures, antiepileptic drug was added to treatment; seizures were controlled with monotherapy. It is known that patients with multiple sclerosis experience seizures. Multiple sclerosis should be considered in the differential diagnosis of young patients presenting with seizures.