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[Paroxysmal dyskinesias as the initial manifestation of multiple sclerosis]
Abstract:
We herein report two patients with paroxysmal dyskinesias (PD) as the initial manifestation of multiple sclerosis (MS). PD can occur in clinically definite MS or rarely be the presenting symptom. They are produced by demyelinating lesions at any level in the motor pathway or in the thalamus. MRI disclosed an area of demyelination in the posterior limb of the internal capsule contralateral to the PD in the patients reported herein. PD associated with MS do not adjust completely to the accepted classifications of PD, therefore they should be considered a special category of dyskinesias.
Insights
Paroxysmal dyskinesias (PD) can be an early sign of multiple sclerosis (MS). These movement disorders, linked to demyelination, may represent a unique category of dyskinesias.
Area of Science:
- Neurology
- Neuroimmunology
- Movement Disorders
Background:
- Paroxysmal dyskinesias (PD) are characterized by involuntary, brief, and episodic movements.
- Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
- PD can be a presenting symptom of MS, though less common than other neurological manifestations.
Observation:
- Two patients presented with paroxysmal dyskinesias (PD) as their first noticeable symptom of multiple sclerosis (MS).
- Magnetic Resonance Imaging (MRI) revealed demyelination in the posterior limb of the internal capsule, contralateral to the affected side with PD.
- These lesions suggest a direct link between demyelination in specific motor pathways and the occurrence of PD.
Findings:
- The observed PD in these MS patients did not fit neatly into existing classifications of dyskinesias.
- Demyelinating lesions in the motor pathways or thalamus are implicated in the generation of PD in MS.
- The findings highlight a specific subtype of dyskinesia associated with MS.
Implications:
- This study suggests that PD should be considered a distinct category when associated with MS.
- Early identification of PD may aid in the diagnosis of MS in some individuals.
- Understanding the neuroanatomical basis of PD in MS can inform future diagnostic and therapeutic strategies.