Prevalence and predictive factors of epilepsy in multiple sclerosis: A cross-sectional study from Saudi Arabia.

PMID 41935523 | DOI 10.1016/j.msard.2026.107169 · Multiple sclerosis and related disorders · 2026

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BACKGROUND: Epilepsy is a well-established comorbidity in multiple sclerosis (MS), with higher prevalence among MS patients than in the general population. This study determines the prevalence of epilepsy in MS patients and identifies associated risk factors in a Saudi cohort. METHODS: This cross-sectional study included adult MS patients at King Abdulaziz Medical City, Jeddah, Saudi Arabia, between 2016 and 2024. Data were retrospectively collected from electronic medical records. Statistical analyses assessed associations between epilepsy and MS-related variables. RESULTS: Among 602 MS patients, 22 had epilepsy, yielding a prevalence of 3.65% (95% CI: 2.16%-5.15%). MS patients with epilepsy were significantly older (median: 45 years) than those without (median: 39 years; p = 0.043). Focal onset motor seizures (50%) and generalized tonic-clonic seizures (42.9%) were most common. MRI revealed cortical lesions in 59%, juxtacortical in 22.7%, and subcortical in 13.6%. Age was a significant predictor, with each additional year increasing epilepsy risk by 5% (OR: 1.05; 95% CI: 1.01-1.09; p = 0.026). CONCLUSION: This study confirms increased epilepsy prevalence among MS patients in Saudi Arabia. Older age is a key risk factor, emphasizing the importance of early screening and management strategies.