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Paroxysmal symptoms as the first manifestations of multiple sclerosis

J A Twomey, M L Espir

    Journal of Neurology, Neurosurgery, and Psychiatry
    |April 1, 1980
    PubMed

    Insights

    Paroxysmal symptoms can be the initial sign of multiple sclerosis (MS), appearing years before other definitive MS signs. This study highlights these early neurological events in MS patients.

    Area of Science:

    • Neurology
    • Neuroimmunology

    Background:

    • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
    • Paroxysmal symptoms, though less common, can present as initial manifestations of MS.

    Purpose of the Study:

    • To investigate the clinical features of paroxysmal symptoms as initial manifestations of multiple sclerosis (MS).
    • To review and compare these cases with previously reported literature.

    Main Methods:

    • Case series of 14 patients with suspected or definite MS experiencing paroxysmal symptoms.
    • Literature review of 153 previously reported cases, focusing on 36 with initial paroxysmal symptoms.
    • Analysis of paroxysmal symptoms originating from the brainstem and spinal cord.

    Main Results:

    • Seven of 14 patients presented with paroxysmal symptoms as their first sign of MS.
    • Paroxysmal symptoms included dysarthria, ataxia, diplopia, tonic seizures, akinesia, sensory disturbances, and pain.
    • Remission periods between initial paroxysmal symptoms and other MS manifestations ranged from less than one to 21 years.

    Conclusions:

    • Paroxysmal symptoms can be a significant early indicator of multiple sclerosis.
    • These transient neurological events may precede definitive MS diagnosis by many years, necessitating careful clinical evaluation.

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