Francesca Forcina
Epilepsy and myasthenia gravis, clues of a complex interplay: case series and review of the literature
Autori
- FRANCESCA FORCINA (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- ANDREA CASCIANELLI (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- ANTONIO LAULETTA (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- ELENA ROSSINI (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- LUCA LEONARDI (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- MATTEO GARIBALDI (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- STEFANIA MORINO (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- LAURA TUFANO (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- MARCO SALVETTI (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- PAOLO TISEI (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- GIOVANNI ANTONINI (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
- LAURA FIONDA (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA – NEUROLOGIA)
Presentatore
FRANCESCA FORCINA (DIPARTIMENTO DI NEUROSCIENZE SALUTE MENTALE E ORGANI DI SENSO (NESMOS), SAPIENZA UNIVERSITÀ DI ROMA, UOC NEUROLOGIA, AOU SANT’ANDREA, ROMA)
Modalità
Poster Session
Abstract
“The association between myasthenia gravis (MG) and epilepsy has been rarely described and it remains unclear whether there is a common underlying mechanism. Moreover, there are currently no guidelines for concomitant therapeutic management. Aimed to describe the clinical features of this association, we report a case series of MG-epilepsy and data from a review on this topic.
We retrospectively reviewed clinical, neurophysiological, radiological and therapeutic-response features of patients with MG-epilepsy recorded in our internal database and systematically searched for this association in the available literature.
Six female patients, aged 7-28 years at epilepsy onset and 26-70 years at MG onset, were included in the study. In all cases MG onset followed epilepsy diagnosis. MGFA was IIIB in 3 patients and IIB in the others. Three patients were positive for anti-AChR antibodies, one for anti-MuSK, whereas two patients were seronegative. Thymectomy, performed in 3 patients, revealed thymic hyperplasia in one of them. All patients required more than one immunosuppressant for MG treatment, and cycles of IVIG or plasma-exchange for exacerbations. Three patients had other autoimmune diseases.
Five patients had focal epilepsy. One patient had generalized epilepsy. Two patients had catamenial seizures. Brain MRI and EEG findings were unremarkable in all but one patient, who had focal cortical dysplasia (FCD). Four patients required more than one anti-seizure medication and two had a drug-resistant epilepsy.
Epilepsy-MG is a rare association, but the possibility that it is more than a mere chance should be considered, focusing on possible autoimmune mechanism underlying both diseases.”