Paroxysmal Limb Hemiataxia With Crossed Facial Paresthesias in Multiple Sclerosis

Skillrud, David M.; Goldstein, Norman

doi:10.1001/jama.1983.03340200077035

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…More than 60 cases of PDA in MS have been documented to date [99,103,[105][106][107][108]. Furthermore, paroxysmal limb hemiataxia with crossed facial paresthesia may also occur in MS, albeit rarely [109,110]. The causative lesion is localized in the upper part of the pons, affecting the ventral central trigeminal tract, brachium conjunctivum, and lateral spinothalamic tract [110].…”

Section: ) Ataxiamentioning

confidence: 99%

“…Levetiracetam has also been shown to significantly improve tremor and ataxia in a small pilot study of 14 patients with MS [56]. Standard antiepileptics, such as carbamazepine [99,100], levetiracetam [105], lacosamide [102], phenytoin [110], and acetazolamide [108] have been effective in PDA related to episodic events in MS. Goodwin and Carpenter [105] reported PDA in a 37-year-old woman approximately three months after a multifocal MS relapse. The lesions were in the posterior midbrain and the right posterior internal capsule [105].…”

Section: ) Ataxiamentioning

confidence: 99%

See 1 more Smart Citation

Movement Disorders in Multiple Sclerosis: An Update

Ghosh

Roy

Dubey

et al. 2022

Tremor and Other Hyperkinetic Movements

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Background: Multiple sclerosis (MS), a subset of chronic primary inflammatory demyelinating disorders of the central nervous system, is closely associated with various movement disorders. These disorders may be due to MS pathophysiology or be coincidental. This review describes the full spectrum of movement disorders in MS with their possible mechanistic pathways and therapeutic modalities. Methods:The authors conducted a narrative literature review by searching for 'multiple sclerosis' and the specific movement disorder on PubMed until October 2021. Relevant articles were screened, selected, and included in the review according to groups of movement disorders. Results:The most prevalent movement disorders described in MS include restless leg syndrome, tremor, ataxia, parkinsonism, paroxysmal dyskinesias, chorea and ballism, facial myokymia, including hemifacial spasm and spastic paretic hemifacial contracture, tics, and tourettism. The anatomical basis of some of these disorders is poorly understood; however, the link between them and MS is supported by clinical and neuroimaging evidence. Treatment options are disorder-specific and often multidisciplinary, including pharmacological, surgical, and physical therapies.Discussion: Movements disorders in MS involve multiple pathophysiological processes and anatomical pathways. Since these disorders can be the presenting symptoms, they may aid in early diagnosis and managing the patient, including monitoring disease progression. Treatment of these disorders is a challenge. Further work needs to be done to understand the prevalence and the pathophysiological mechanisms responsible for movement disorders in MS.

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Section: ) Ataxiamentioning

confidence: 99%

Section: ) Ataxiamentioning

confidence: 99%

Movement Disorders in Multiple Sclerosis: An Update

Ghosh

Roy

Dubey

et al. 2022

Tremor and Other Hyperkinetic Movements

View full text Add to dashboard Cite

show abstract

Section: Paroxysmal Symptoms Categoriesmentioning

confidence: 99%

“…Hemiataxia and crossed paresthesia is another paroxysmal syndrome described in MS, albeit much less frequent than PDA, with only three reported cases [ 7 , 98 ]. Abnormal blink reflex responses localize the lesion to the pons [ 98 ]. A lesion in the upper part of the pons affecting the brachium conjunctivum, ventral central trigeminal tract and lateral spinothalamic tract may explain these crossed symptoms [ 7 ].…”

Section: Paroxysmal Symptoms Categoriesmentioning

confidence: 99%

“…There is no evidence-based approach on how to treat MS patients with paroxysmal ataxia and the effectiveness of various treatments is based on case reports. Standard antiepileptics such as carbamazepine [ 94 , 95 ], levetiracetam [ 91 ], lamotrigine [ 100 ], lacosamide [ 92 ], and phenytoin [ 98 ] were found to be effective in aborting ataxic episodes. One reported patient with attacks refractory to steroid and various antiepileptic treatments, achieved full recovery after 1 month of treatment with fingolimod [ 96 ].…”

Section: Paroxysmal Symptoms Categoriesmentioning

confidence: 99%

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Paroxysmal Symptoms in Multiple Sclerosis—A Review of the Literature

Freiha

Riachi

Chalah

et al. 2020

JCM

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Paroxysmal symptoms are well-recognized manifestations of multiple sclerosis (MS). These are characterized by multiple, brief, sudden onset, and stereotyped episodes. They manifest as motor, sensory, visual, brainstem, and autonomic symptoms. When occurring in the setting of an established MS, the diagnosis is relatively straightforward. Conversely, the diagnosis is significantly more challenging when they occur as the initial manifestation of MS. The aim of this review is to summarize the various forms of paroxysmal symptoms reported in MS, with emphasis on the clinical features, radiological findings and treatment options.

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Diagnostic Reference Index of Clinical Neurology

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Paroxysmal Limb Hemiataxia With Crossed Facial Paresthesias in Multiple Sclerosis

Cited by 4 publications

References 6 publications

Movement Disorders in Multiple Sclerosis: An Update

Movement Disorders in Multiple Sclerosis: An Update

Paroxysmal Symptoms in Multiple Sclerosis—A Review of the Literature

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