Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report

<p>Abstract</p> <p>Background</p> <p>Multiple sclerosis (MS) is considered an autoimmune disease of the central nervous system and therapeutic inhibition of leukocyte migration with natalizumab, an anti-alpha4 integrin antibody, is highly effective in patients with MS....

Full description

Bibliographic Details
Main Authors: Constantin Gabriela, Murrighile Maria R, Sotgiu Stefano
Format: Article
Language:English
Published: BMC 2010-09-01
Series:BMC Neurology
Online Access:http://www.biomedcentral.com/1471-2377/10/84
_version_ 1818120298980966400
author Constantin Gabriela
Murrighile Maria R
Sotgiu Stefano
author_facet Constantin Gabriela
Murrighile Maria R
Sotgiu Stefano
author_sort Constantin Gabriela
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Multiple sclerosis (MS) is considered an autoimmune disease of the central nervous system and therapeutic inhibition of leukocyte migration with natalizumab, an anti-alpha4 integrin antibody, is highly effective in patients with MS. Recent studies performed in experimental animal models with relevance to human disease suggested a key role for blood-brain barrier damage and leukocyte trafficking mechanisms also in the pathogenesis of epilepsy. In addition, vascular alterations and increased leukocyte accumulation into the brain were recently documented in patients with refractory epilepsy independently on the disease etiology.</p> <p>Case report</p> <p>Here we describe the clinical course of a 24-year-old patient with MS in whom abrupt tonic-clonic generalized seizures manifested at disease onset. Although MS had a more favorable course, treatment with glatiramer acetate and antiepileptic drugs for 7 years had no control on seizure generation and the patient developed severe refractory epilepsy. Interestingly, generalized seizures preceded new MS relapses suggesting that seizure activity may contribute to MS worsening creating a positive feedback loop between the two disease conditions. Notably, treatment with natalizumab for 12 months improved MS condition and led to a dramatic reduction of seizures.</p> <p>Conclusion</p> <p>Our case report suggests that inhibition of leukocyte adhesion may represent a new potential therapeutic approach in epilepsy and complement the traditional therapy with anti-epileptic drugs.</p>
first_indexed 2024-12-11T05:23:53Z
format Article
id doaj.art-218f46c9b49c45e4ab712f213fae4ee2
institution Directory Open Access Journal
issn 1471-2377
language English
last_indexed 2024-12-11T05:23:53Z
publishDate 2010-09-01
publisher BMC
record_format Article
series BMC Neurology
spelling doaj.art-218f46c9b49c45e4ab712f213fae4ee22022-12-22T01:19:37ZengBMCBMC Neurology1471-23772010-09-011018410.1186/1471-2377-10-84Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case reportConstantin GabrielaMurrighile Maria RSotgiu Stefano<p>Abstract</p> <p>Background</p> <p>Multiple sclerosis (MS) is considered an autoimmune disease of the central nervous system and therapeutic inhibition of leukocyte migration with natalizumab, an anti-alpha4 integrin antibody, is highly effective in patients with MS. Recent studies performed in experimental animal models with relevance to human disease suggested a key role for blood-brain barrier damage and leukocyte trafficking mechanisms also in the pathogenesis of epilepsy. In addition, vascular alterations and increased leukocyte accumulation into the brain were recently documented in patients with refractory epilepsy independently on the disease etiology.</p> <p>Case report</p> <p>Here we describe the clinical course of a 24-year-old patient with MS in whom abrupt tonic-clonic generalized seizures manifested at disease onset. Although MS had a more favorable course, treatment with glatiramer acetate and antiepileptic drugs for 7 years had no control on seizure generation and the patient developed severe refractory epilepsy. Interestingly, generalized seizures preceded new MS relapses suggesting that seizure activity may contribute to MS worsening creating a positive feedback loop between the two disease conditions. Notably, treatment with natalizumab for 12 months improved MS condition and led to a dramatic reduction of seizures.</p> <p>Conclusion</p> <p>Our case report suggests that inhibition of leukocyte adhesion may represent a new potential therapeutic approach in epilepsy and complement the traditional therapy with anti-epileptic drugs.</p>http://www.biomedcentral.com/1471-2377/10/84
spellingShingle Constantin Gabriela
Murrighile Maria R
Sotgiu Stefano
Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report
BMC Neurology
title Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report
title_full Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report
title_fullStr Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report
title_full_unstemmed Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report
title_short Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report
title_sort treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis case report
url http://www.biomedcentral.com/1471-2377/10/84
work_keys_str_mv AT constantingabriela treatmentofrefractoryepilepsywithnatalizumabinapatientwithmultiplesclerosiscasereport
AT murrighilemariar treatmentofrefractoryepilepsywithnatalizumabinapatientwithmultiplesclerosiscasereport
AT sotgiustefano treatmentofrefractoryepilepsywithnatalizumabinapatientwithmultiplesclerosiscasereport