Figure 2From: Treatment of refractory epilepsy with natalizumab in a patient with multiple sclerosis. Case report Effect of Natalizumab on seizure frequency and EEG tracks. A. Bars indicate the number of episodes of partial (yellow) and generalized (blue) seizures along the 10-years period. After natalizumab introduction (arrow), the number (Y axis) of partial seizure dramatically dropped from 10 to 4 (60% reduction), while generalized seizures disappeared. T-test (two-tailed 95% confidence interval) was used to test the null hypothesis (number of seizures after the start of natalizumab is not different from the mean of the 2002-2008 period). Mean values were 6.71 ± 2.21 (95% CI 3.22-5.62) for partial seizures and 4.43 ± 1.81 (95% CI 5.24-8.17) for generalized seizures, respectively. One tailed p-values are 0.003 for partial (*) and 0.00004 for generalized (**) seizures, allowing to strongly reject the null hypothesis. B. Intercritical scalp EEG recording (18'' duration) of the case, performed while awake on July 2008 and showing a reactivation of a focus of sharp waves and low-amplitude slow activity over the left fronto-temporal region, which correspond to a complex partial seizure accompanied by gestural automatisms. The patient was on therapy with GA and on poly-AEDs treatment (oxcarbazepine 2400 mg/day, levetiracetam 3000 mg/day and gabapentin 900 mg/day). C. Intercritical scalp EEG recording (18'' duration) performed on June 2009 while awake, showing minimal low-amplitude slow activity over the left fronto-temporal region. The patient was on therapy with natalizumab and on poly-AEDs treatment with levetiracetam 2000 mg/day (33% reduction) and gabapentin 900 mg/day. Scalp EEG recording set up: PA filter 0.53 Hz; PB filter 30 Hz, amplitude 70 microvolt/cm. Electrode placement refers to the Jasper's 10-20 system. EKG = electrocardiogram.Back to article page