What Are Paroxysmal Symptoms of Multiple Sclerosis?

Short-Lasting Symptoms That Come and Go

Coping with illness can be challenging
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One of the characteristics of multiple sclerosis (MS) is the sometimes-frustrating way in which symptoms can suddenly appear out of nowhere, last for a few minutes or even seconds, and then disappear just as quickly.

We refer to these types of symptom as paroxysmal. They can appear as a once-off event or repeat in cycles over the course of hours or days. Intermittent events are commonly referred to as clusters, surges, or episodes depending on the types of symptoms involved.

Paroxysmal symptoms can be worrisome to people with MS who may otherwise be managing their disease just fine. To some, a sudden and short-lasting attack may suggest that a relapse is imminent or that their disease is progressing.

But is that necessarily the case? What causes these symptoms, and is there any real reason for panic?

Causes of Paroxysmal Symptoms in MS

The paroxysmal symptoms of MS are typically the result of an existing damage to nerves. The hallmark of the disease is the way in which the body’s immune response progressively destroys the protective covering of nerves called the myelin sheath. Once the damage has been done, it is difficult to restore.

As such, these nerves are vulnerable to flare-ups simply because they are naked and exposed, much like electrical wiring without the insulated coating. Moreover, it often takes little to trigger symptoms. Even something as innocuous as touch, temperature, humidity, stress, or fatigue may be enough to set off a neurological response.

Types of Paroxysmal Symptoms in MS

While research suggests that three percent of people with MS are affected by paroxysmal symptoms, that figure could be even higher given that many cases go unreported.

In and of themselves, paroxysmal symptoms are not considered an indication of relapse unless the symptoms are continuous or new.

Paroxysmal symptoms, by contrast, come in short bursts and, while persistent in some cases, tend to subside over time. The types of symptoms that can appear in a paroxysmal way include:

  • Diplopia, also known as double vision, is caused by a weakness in the muscles controlling the eyes.
  • Paresthesias are abnormal sensations on the face, trunk, or limbs, often described as a tingling, burning, itching, numbness, or "pins-and-needles" sensation.
  • Trigeminal neuralgia is an intense pain occurring in the lower part of the face, often triggered by chewing or speaking.
  • Episodic ataxia is a sudden unsteadiness or lack of coordination, often causing people to stumble or drop things.
  • Dysarthria and dysphonia are a speech disorders that cause slurring, slowed speech, changes in the volume, or strange speech rhythms.
  • Lhermitte’s sign is a painful, electrical shock-like sensation which runs down the spine when the head is bent forward.
  • Pruritus is a localized or generalized itchiness.
  • Dystonia is the disruption of voluntary muscle control or the sustained spasm in a group of muscles.
  • Dysphagia is the loss of control of muscles involved in swallowing.

A Word from Verywell

While there is no cure for MS, most symptoms of the disease can be managed with proper treatment.

In the case of paroxysmal symptoms, the good news is that they tend to go away after several weeks or months and usually don't return.

In the meantime, many paroxysmal attacks can be controlled with low-dose prescription medications. Speak with your doctor if experiencing any transient symptoms, however minor, or if certain symptoms are either not going away or increasing in frequency.

Source:

Yates, T. and Crawley, F. "Paroxysmal symptoms in multiple sclerosis masquerading as transient ischaemic attacks." BMJ Case Rep. 2010;2010:bcr0320102831.

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