Paroxysmal Symptoms

Paroxysmal symptoms refer to a sudden onset of a neurological symptom, or cluster of symptoms that may last over seconds to minutes, repeating a few to very many intervals per day. They can occur at any time in the course of MS and may vary in intensity and frequency, with or without pain. When these symptom clusters occur over several days, it may be considered to be an MS relapse. They may include (but are not limited to) trigeminal neuralgia, tonic spasms, weakness, dysarthria and ataxia, visual disturbance, numbness and other sensory disturbance, and Lhermitte’s sign.

Management

Management includes ruling out non MS causes of paroxysmal phenomena. Anticonvulsants , particularly carbamazepine are usually helpful. Gabapentin may be helpful as can be benzodiazepines such as clonazepam.

Key Healthcare professionals

• Neurologist
• MS nurse