Case reportsCase I In January 1979, a Japanese woman aged 27 years was admitted to Okayama University Hospital with loss of vision on the left, and frequent attacks of itching affecting initially the lateral side of the right lower leg for two months. These were of sudden onset, lasted only a few minutes and ceased rapidly. The attacks occurred at least five times a day and were not relieved by scratching. Two weeks after the first attack, episodes of itching occurred on the lateral side of the left lower leg and continued for a week in this area. Thereafter, paroxysmal itching migrated to involve both knees, both hips and both lateral thighs. The itching was provoked in both legs whenever she had a hot bath.

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Summary Seven cases of multiple sclerosis with paroxysmal dysesthesias of an upper extremity were reported. This seizure characteristically is a purely sensory one induced by movements and is not accompanied by convulsions or a disorder of voluntary movements. In other ways it shares some features with other paroxysmal manifestations seen in MS. Clinical observations with subsequent neurophysiologic considerations have led to the hypothesis that paroxysmal dysesthesias are segmental symptoms with their foci lying in or about the spinal cord.

Antibody titers to the Epstein-Barr virus (EBV) in the serum and cerebrospinal fluid (CSF) were determined in 57 cases of acute or subacute neurological diseases. As a result, sera from 11 cases (7 Bell's palsy, 2 encephalitis and 2 acute cerebellar ataxia) were found to be positive for antibodies to early antigen. Seven of these 11 cases either seroconverted for IgG antibodies to viral capsid antigen (VCA) or were proven positive for anti-VCA-IgM antibodies in the serum. While 4 were found positive for IgG antibodies to VCA in CSF, 3 tested by the anti-complement immunofluorescence method were all negative for EBV-associated nuclear antigen (EBNA) in CSF. Three of the 11 cases were considered to be of a primary infection with EBV because of a negative serologic test for antibodies to EBNA initially; a reinfection with the virus or a reactivation of the latent infection was suspected in some of the remaining cases.