This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Background and Objectives Epilepsy is an important comorbidity that affects outcomes for people with multiple sclerosis (MS). However, it is unclear whether seizure severity among individuals with coexistence of MS and epilepsy (MS + E) is higher than in those with other focal epilepsies. Our goal was to compare the overall severity of epilepsy in individuals with MS + E vs those with focal epilepsy without MS (E − MS), as defined by seizure-related health care utilization, frequency and duration of status epilepticus, and frequency of antiseizure medication (ASM) regimen changes.
Methods In this hypothesis-generating study, we analyzed a US commercial nationwide deidentified claims data set with >86 million individuals between January 1, 2008, and August 31, 2019. Using validated algorithms, we identified adults with E − MS and those with MS + E. We compared the number and length of seizure-related hospital admissions, the number of claims and unique days with claims for status epilepticus, and the rates of ASM regimen changes between the MS + E and E − MS groups.
Results During the study period, 66,708 individuals with E − MS and 537 with MS + E had ≥2 years of coverage after their initial diagnosis of epilepsy. There was no difference between the MS + E and E − MS groups in the percentage of individuals admitted for seizures and/or status epilepticus. However, MS + E with seizure-related admissions had more admissions and longer hospital stays than those with E − MS. MS + E who experienced status epilepticus had more unique days with status epilepticus claims compared with E − MS. MS + E were more likely to have ASM regimen changes in 2 years after the initial diagnosis of epilepsy and had more ASM changes during 2 years compared with E − MS. Among individuals with MS + E, there were no differences in our measures of seizure severity for those treated with sodium channel blockers/modulators vs other ASM classes.
Discussion This study supports the notion that individuals with MS + E can have more severe epilepsy than those with E − MS. Seizure severity among individuals with MS + E treated with sodium channel blockers/modulators vs other ASM classes shows no significant differences.
Classification of Evidence This study provides Class III evidence that individuals with MS + E can have more severe epilepsy than those with E − MS.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Submitted and externally peer reviewed. The handling editors were Former Associate Editor Richard Barbano, MD, PhD, FAAN, and Editor Luca Bartolini, MD.
Class of Evidence: NPub.org/coe
- Received August 20, 2021.
- Accepted April 26, 2022.
- © 2022 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
The Nerve!: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hemiplegic Migraine Associated With PRRT2 Variations A Clinical and Genetic Study
Dr. Robert Shapiro and Dr. Amynah Pradhan