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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1980 Apr;43(4):296–304. doi: 10.1136/jnnp.43.4.296

Paroxysmal symptoms as the first manifestations of multiple sclerosis.

J A Twomey, M L Espir
PMCID: PMC490532  PMID: 7373330

Abstract

Paroxysmal symptoms are described in 14 patients with undoubted or suspected multiple sclerosis (MS). In seven of the patients the paroxysms were the first symptom of the disease, although only one has developed definite MS so far. The clinical features have been compared with 153 patients previously reported in the literature which has been reviewed, with special reference to 36 in whom paroxysmal symptoms were the initial manifestations of MS. Attention has been focused on paroxysmal symptoms of brain stem and spinal cord origin of the following types: paroxysmal dysarthria and ataxia, diplopia, tonic seizures, paroxysmal akinesia, paroxysmal sensory disturbances and pains. Examples of each type have been reported as the first symptoms of MS with remissions ranging from less than one to 21 years before other manifestations of MS have developed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ANDERMANN F., COSGROVE J. B., LLOYD-SMITH D., WALTERS A. M. Paroxysmal dysarthria and ataxia in multiple sclerosis; a report of 2 unusual cases. Neurology. 1959 Apr;9(4):211–215. doi: 10.1212/wnl.9.4.211. [DOI] [PubMed] [Google Scholar]
  2. BLOM S. Diphenylhydantoin and lidocaine in decerebrate cats. Arch Neurol. 1963 May;8:506–509. doi: 10.1001/archneur.1963.00460050056006. [DOI] [PubMed] [Google Scholar]
  3. Becker F. O., Michael J. A., Davis F. A. Acute effects of oral phosphate on visual function in multiple sclerosis. Neurology. 1974 Jul;24(7):601–607. doi: 10.1212/wnl.24.7.601. [DOI] [PubMed] [Google Scholar]
  4. Castaigne P., Cambier J., Masson M., Brunet P., Lechevallier B., Delaporte P., Dehen H. Les manifestations motrices paroxystiques de la sclérose en plaques. Presse Med. 1970 Oct 24;78(44):1921–1924. [PubMed] [Google Scholar]
  5. Davis F. A., Becker F. O., Michael J. A., Sorensen E. Effect of intravenous sodium bicarbonate, disodium edetate (Na2EDTA), and hyperventilation on visual and oculomotor signs in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1970 Dec;33(6):723–732. doi: 10.1136/jnnp.33.6.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Davis F. A., Bergen D., Schauf C., McDonald I., Deutsch W. Movement phosphenes in optic neuritis: a new clinical sign. Neurology. 1976 Nov;26(11):1100–1104. doi: 10.1212/wnl.26.11.1100. [DOI] [PubMed] [Google Scholar]
  7. DeCastro E., Campbell J. Periodic ataxia. JAMA. 1967 Jun 5;200(10):892–894. [PubMed] [Google Scholar]
  8. Ekbom K. A., Westerberg C. E., Osterman P. O. Focal sensory-motor seizures of spinal origin. Lancet. 1968 Jan 13;1(7533):67–67. doi: 10.1016/s0140-6736(68)90067-6. [DOI] [PubMed] [Google Scholar]
  9. Espir M. L., Millac P. Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine (Tegretol). J Neurol Neurosurg Psychiatry. 1970 Aug;33(4):528–531. doi: 10.1136/jnnp.33.4.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Espir M. L., Watkins S. M., Smith H. V. Paroxysmal dysarthria and other transient neurological disturbances in disseminated sclerosis. J Neurol Neurosurg Psychiatry. 1966 Aug;29(4):323–330. doi: 10.1136/jnnp.29.4.323. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Fabri S., Millefiorini M. Crisi toniche in un caso di sclerosi multipla. Riv Neurol. 1965 Mar-Apr;35(2):161–168. [PubMed] [Google Scholar]
  12. Fromm G. H., Killian J. M. Effect of some anticonvulsant drugs on the spinal trigeminal nucleus. Neurology. 1967 Mar;17(3):275–280. doi: 10.1212/wnl.17.3.275. [DOI] [PubMed] [Google Scholar]
  13. Harrison M., McGill J. I. Transient neurological distrubances in disseminated sclerosis: a case report. J Neurol Neurosurg Psychiatry. 1969 Jun;32(3):230–232. doi: 10.1136/jnnp.32.3.230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. JOYNT R. J., GREEN D. Tonic seizures as a manifestation of multiple sclerosis. Arch Neurol. 1962 Apr;6:293–299. doi: 10.1001/archneur.1962.00450220035006. [DOI] [PubMed] [Google Scholar]
  15. KUROIWA Y., ARAKI S. Lhermitte's sign and reflex tonic spasm in demyelinating diseases with special reference to their localizing value. Kyushu J Med Sci. 1963 Feb;14:29–38. [PubMed] [Google Scholar]
  16. Kuroiwa Y., Shibasaki H. Painful tonic seizure in multiple sclerosis treatment with diphenylhydantoin and carbamazepine. Folia Psychiatr Neurol Jpn. 1968;22(2):107–119. doi: 10.1111/j.1440-1819.1968.tb01314.x. [DOI] [PubMed] [Google Scholar]
  17. LANCE J. W. Sporadic and familial varieties of tonic seizures. J Neurol Neurosurg Psychiatry. 1963 Feb;26:51–59. doi: 10.1136/jnnp.26.1.51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. MATTHEWS W. B. Tonic seizures in disseminated sclerosis. Brain. 1958 Jun;81(2):193–206. doi: 10.1093/brain/81.2.193. [DOI] [PubMed] [Google Scholar]
  19. Matthews W. B. Paroxysmal symptoms in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1975 Jun;38(6):617–623. doi: 10.1136/jnnp.38.6.617. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. McDonald W. I., Halliday A. M. Diagnosis and classification of multiple sclerosis. Br Med Bull. 1977 Jan;33(1):4–9. [PubMed] [Google Scholar]
  21. Miley C. E., Forster F. M. Paroxysmal signs and symptoms in multiple sclerosis. Neurology. 1974 May;24(5):458–461. doi: 10.1212/wnl.24.5.458. [DOI] [PubMed] [Google Scholar]
  22. Netsell R., Kent R. D. Paroxysmal ataxic dysarthria. J Speech Hear Disord. 1976 Feb;41(1):93–109. doi: 10.1044/jshd.4101.93. [DOI] [PubMed] [Google Scholar]
  23. Osterman P. O. Paroxysmal itching in multiple sclerosis. Br J Dermatol. 1976 Nov;95(5):555–558. doi: 10.1111/j.1365-2133.1976.tb00869.x. [DOI] [PubMed] [Google Scholar]
  24. Ostermann P. O., Westerberg C. E. Paroxysmal attacks in multiple sclerosis. Brain. 1975 Jun;98(2):189–202. doi: 10.1093/brain/98.2.189. [DOI] [PubMed] [Google Scholar]
  25. Perks W. H., Lascelles R. G. Paroxysmal brain stem dysfunction as presenting feature of multiple sclerosis. Br Med J. 1976 Nov 13;2(6045):1175–1176. doi: 10.1136/bmj.2.6045.1175-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Shibasaki H., Kuroiwa Y. Painful tonic seizure in multiple sclerosis. Arch Neurol. 1974 Jan;30(1):47–51. doi: 10.1001/archneur.1974.00490310049008. [DOI] [PubMed] [Google Scholar]
  27. Voiculescu V., Pruskauer-Apostol B., Alecu C. Treatment with acetazolamide of brain-stem and spinal paroxysmal disturbances in multiple sclerosis. J Neurol Neurosurg Psychiatry. 1975 Feb;38(2):191–193. doi: 10.1136/jnnp.38.2.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Wolf P., Assmus H. Paroxysmale Dysarthrie und Ataxie. Ein pathognomonisches Anfallssyndrom bei multipler Sklerose. J Neurol. 1974;208(1):27–38. doi: 10.1007/BF00313331. [DOI] [PubMed] [Google Scholar]
  29. ZELDOWICZ L. Paroxysmal motor episodes as early manifestations of multiple sclerosis. Can Med Assoc J. 1961 Apr 29;84:937–941. [PMC free article] [PubMed] [Google Scholar]

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