[Paroxysmal itching and magnetic resonance imaging of the spinal cord in multiple sclerosis]

In three women with multiple sclerosis, paroxysmal itching occurred. We were able to detect the spinal segment lesions corresponding to the dermatome of paroxysmal itching by magnetic resonance imaging (MRI) in them. Case 1. A 38-year-old woman was admitted with chief complaints of tingling sensation in the left side of the body, left hemiparesis and paroxysmal itching in the neck and left upper extremity. Examination on admission revealed left hemiparesis, mildly exaggerated deep tendon reflexes in the left upper and lower extremities, positive Lhermitte's sign. Superficial sensation was decreased and dysesthetic below the left C3 segment. Vibration and joint sense were moderately decreased in the left upper limb. Painful tonic seizure-like attack occurred in the neck bilaterally. Paroxysmal itching occurred in the neck and left upper extremity corresponding to the cervical spinal segments bilateral C3, left C4 to C6. MRI revealed multiple high signal intensities in the white matter of the cerebral hemispheres, the medullo-cervical junction and the cervical segment C3 to C4 in T2-weighted spin-echo images. The C3 to C4 lesion was found in the left dorsal area of spinal cord in axial image. High signal areas of cervical cords on T2-weighted spin-echo images were reduced in response to adrenocorticosteroid therapy, and paroxysmal itching disappeared. Case 2. A 24-year-old woman complained chiefly of mild tetraparesis and left hand clumsiness. On admission, she had right central facial palsy, mild weakness of all limbs, painful tonic seizure of left upper limb, positive Lhermitte's sign and bilateral Babinski sign. Superficial sense was mildly decreased and dysesthetic in left upper extremity.(ABSTRACT TRUNCATED AT 250 WORDS)