Paroxysmal pruritus and multiple sclerosis

Koeppel, M.C.; Bramont, C.; Ceccaldi, Mathieu; Habib, M; Sayag, J

doi:10.1111/j.1365-2133.1993.tb00492.x

Cited by 32 publications

(20 citation statements)

References 15 publications

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“…The lack of pharmacologic benefit of peripherally acting drugs in our patients may strengthen our hypothesis of a central origin for the pruritus. Central itch is not uncommon and has been previously described in a variety of CNS disorders including multiple sclerosis [30], stroke [31], tumors of the fourth ventricle [32], brain abscess [33], and surgery for basilar artery aneurysm [34].…”

Section: Discussionmentioning

confidence: 99%

Pruritus in familial Creutzfeldt–Jakob disease: a common symptom associated with central nervous system pathology

et al. 2010

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Pruritus, a common feature of animal prion diseases such as scrapie, is rarely reported in humans with Creutzfeldt-Jakob disease (CJD), and its anatomical background is not well defined. The present study was undertaken to carry out a methodical prospective search for the prevalence of pruritus in CJD patients and investigate its anatomical substrate by MRI. The study group included consecutive familial and sporadic CJD patients carrying the E200K PRNP mutation followed up in a longitudinal prospective study between the years 2005 and 2008. Pruritus was prospectively screened for and diffusion-weighted imaging (DWI) was used to correlate brain diffusion abnormalities with pruritus in CJD patients. Pruritus was present in 6/31 (19.35%) patients with familial disease (fCJD) and in none of the patients with sporadic disease (sCJD). Pruritus was a presenting symptom in one patient and evolved during the course of the disease in the other five patients. The pruritus was generalized in three patients, regional in two and localized in one patient. It was transient in one patient and continued throughout the disease in five patients. DWI showed that pruritus was significantly associated with reduced diffusion in the several areas known to be affected by CJD, but most significantly in the midbrain periaqueductal grey matter. Pruritus is relatively common in patients with familial CJD carrying the E200K mutation. Our findings point to a central origin that involves damage to the inhibitory gating mechanism for itch in the periaqueductal grey matter.

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Section: Discussionmentioning

confidence: 99%

Pruritus in familial Creutzfeldt–Jakob disease: a common symptom associated with central nervous system pathology

et al. 2010

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“…In contrast, polyneuropathies arise from generalized peripheral nerve damage [104]. Finally, NI syndromes can also arise from lesions within the spinal cord (e.g., multiple sclerosis) and in the brain (stroke) [105][106][107]. In the brain, any types of lesions that damage itch circuitry can cause NI.…”

Section: The Neuropathic Itchmentioning

confidence: 99%

The Neuropathic Itch Caused by Pseudorabies Virus

Laval

Enquist

2020

Pathogens

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Pseudorabies virus (PRV) is an alphaherpesvirus related to varicella-zoster virus (VZV) and herpes simplex virus type 1 (HSV1). PRV is the causative agent of Aujeskzy’s disease in swine. PRV infects mucosal epithelium and the peripheral nervous system (PNS) of its host where it can establish a quiescent, latent infection. While the natural host of PRV is the swine, a broad spectrum of mammals, including rodents, cats, dogs, and cattle can be infected. Since the nineteenth century, PRV infection is known to cause a severe acute neuropathy, the so called “mad itch” in non-natural hosts, but surprisingly not in swine. In the past, most scientific efforts have been directed to eradicating PRV from pig farms by the use of effective marker vaccines, but little attention has been given to the processes leading to the mad itch. The main objective of this review is to provide state-of-the-art information on the mechanisms governing PRV-induced neuropathic itch in non-natural hosts. We highlight similarities and key differences in the pathogenesis of PRV infections between non-natural hosts and pigs that might explain their distinctive clinical outcomes. Current knowledge on the neurobiology and possible explanations for the unstoppable itch experienced by PRV-infected animals is also reviewed. We summarize recent findings concerning PRV-induced neuroinflammatory responses in mice and address the relevance of this animal model to study other alphaherpesvirus-induced neuropathies, such as those observed for VZV infection.

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“…Pruritus has been described in the context of demyelinating diseases of the CNS including neuromyelitis optica spectrum disorders (NMOSD) and MS [ 57 , 58 ]. Paroxysmal pruritus may occur in isolation or can be a predictive symptom immediately before an exacerbation or occur in the recovery phase of a sensory or motor attack [ 59 , 60 , 61 , 62 ]. The intense itching often occurs during sleep and follows a specific dermatomal distribution, depending on the location of the lesion in the spinal cord.…”

Section: Paroxysmal Symptoms Categoriesmentioning

confidence: 99%

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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Paroxysmal pruritus and multiple sclerosis

Abstract: We report a patient who presented with paroxysmal pruritus in association with multiple sclerosis. Magnetic resonance imaging of the cervical spinal cord showed a lesion at a level corresponding to the dermatomal location of the pruritus.

Cited by 32 publications

References 15 publications

Pruritus in familial Creutzfeldt–Jakob disease: a common symptom associated with central nervous system pathology

Pruritus in familial Creutzfeldt–Jakob disease: a common symptom associated with central nervous system pathology

The Neuropathic Itch Caused by Pseudorabies Virus

Paroxysmal Symptoms in Multiple Sclerosis—A Review of the Literature

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