Symptom Management

Seizures in MS

By Greg Robert Zarelli, M.D.

One of the less common problems associated with MS is seizures. Their incidence among the MS population has been estimated to be as much as 5 percent, compared to only 3 percent in the general population. While seizures may occur as part of MS, they may also be the result of an infection, fever, or abrupt cessation of certain medications. To understand how an individual with MS could potentially develop a seizure disorder, we have to understand the fundamental make up of the brain.

The brain and spinal cord are composed of two basic substructures: grey matter and white matter. Seizures result from abnormal electrical discharges in the brain arising in the cortex, or grey matter, of the brain. The grey matter is the area of the brain where we do our thinking. It is where we generate the electrical signal to tell our arm to move or where we interpret the sounds we recognize as speech. The white matter, on the other hand, is the wiring of the brain that transports information from one area of the brain to another, and from the brain to the spinal cord. It is the white matter that allows the instructions to be transported to our arm, or to the part of the brain where we interpret speech. 

Recent studies have demonstrated that there is not a distinct line between the grey and white matter. They overlap to some extent. There is some white matter extending into the grey matter. Since MS is a disease of the white matter, that overlap allows an MS plaque to affect the grey matter. This, in turn, can permit a seizure to occur.

Seizures may take several forms:

• Generalized tonic-clonic seizures (a.k.a. grand mal seizures), which are brief episodes of unconsciousness with involuntary jerking movements of the extremities.

• Generalized absence seizures, which are momentary lapses of consciousness without accompanying abnormal movements.

• Partial complex seizures, which are periods of stereotyped repetitive activity in which the person appears to be awake but does not respond to external stimuli.

Treatment Options

Seizures are generally easily controlled with medications such as phenytoin (Dilantin®), carbamazepine (Tegretol®) and valproic acid (Depakote®). Lamotrigine (Lamictal®) and levetiracetam (Keppra®), the newer antiepileptic medications, are also very good.

Some people have had varying degrees of success in minimizing the frequency of seizures with natural healing, such as dietary strategies and neurofeedback. However, the effectiveness of such treatments has not been proven. Before considering any treatment, do your homework and talk to your doctor.

Empower Yourself

If you experience seizures, there are things you can do to empower yourself. Keep a detailed seizure journal. Write down the time, the type of seizure, and its duration. Note any changes in medication, stress, or sleep. Stress and sleep deprivation can increase the incidence of seizures, so get plenty of rest and find positive ways to manage stress. A medical bracelet can be helpful to emergency medical personnel. While seizures can be scary and leave you feeling very confused and tired, they are generally short-lived.

To learn more, check out the resources below:

National Epilepsy Foundation


Epilepsy Therapy Development Project

A board-certified neurologist, “Dr. Z” trained at Baylor College of Medicine in Houston, Texas. His area of specialty is neuro-immunology. Currently, he is Staff Physician in the Department of Neurology at Kaiser-Permanente NW in Clackamas, Oregon. When he’s not working, Dr. Z enjoys traveling and has currently visited 85 countries! He also enjoys running, weightlifting and the arts.

(Last reviewed 7/2009)