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Paroxysmal Symptoms in Multiple Sclerosis-A Review of the Literature
Joumana Freiha1,2, Naji Riachi1,2, Moussa A Chalah3,4
1Gilbert and Rose Mary Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon.
Abstract:
Paroxysmal symptoms are well-recognized manifestations of multiple sclerosis (MS). These are characterized by multiple, brief, sudden onset, and stereotyped episodes. They manifest as motor, sensory, visual, brainstem, and autonomic symptoms. When occurring in the setting of an established MS, the diagnosis is relatively straightforward. Conversely, the diagnosis is significantly more challenging when they occur as the initial manifestation of MS. The aim of this review is to summarize the various forms of paroxysmal symptoms reported in MS, with emphasis on the clinical features, radiological findings and treatment options.
Insights
Paroxysmal symptoms, brief neurological episodes in multiple sclerosis (MS), can be challenging to diagnose, especially as initial symptoms. This review covers their diverse forms, clinical features, and treatment in MS.
Area of Science:
- Neurology
- Neuroimmunology
- Clinical Neuroscience
Background:
- Paroxysmal symptoms are brief, sudden neurological episodes characteristic of multiple sclerosis (MS).
- While common in established MS, they pose diagnostic challenges when presenting as the initial manifestation of the disease.
- These symptoms encompass a wide range, including motor, sensory, visual, brainstem, and autonomic disturbances.
Purpose of the Study:
- To review the varied presentations of paroxysmal symptoms in multiple sclerosis (MS).
- To highlight the clinical characteristics, diagnostic imaging findings, and therapeutic strategies for these episodes.
- To provide a comprehensive overview for clinicians managing MS patients with paroxysmal symptoms.
Main Methods:
- Literature review of studies on paroxysmal symptoms in multiple sclerosis.
- Analysis of clinical case reports and series detailing symptom presentation and diagnosis.
- Synthesis of information regarding neuroimaging findings and treatment outcomes.
Main Results:
- Paroxysmal symptoms in MS manifest diversely, affecting motor, sensory, visual, and autonomic functions.
- Diagnosis is often straightforward in known MS but complex when symptoms are the first sign.
- Review identifies key clinical and radiological features aiding diagnosis and discusses available treatment options.
Conclusions:
- Paroxysmal symptoms are a significant, albeit often overlooked, feature of multiple sclerosis.
- Early recognition and accurate diagnosis, particularly in new-onset cases, are crucial for appropriate management.
- Understanding the spectrum of these symptoms informs diagnostic pathways and treatment selection in MS.
