Symptomatic paroxysmal dysarthria-ataxia in demyelinating diseases

Marcel, Christophe; Anheim, Mathieu; Flamand‐Rouvière, Constance; Héran, F.; Masnou, P.; Boulay, Clotilde; Mari, Ivan; Tranchant, C.; Roze, Emmanuel

doi:10.1007/s00415-010-5534-3

Cited by 32 publications

(20 citation statements)

References 16 publications

(23 reference statements)

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“…An even less common neurological disorder in MS is paroxysmal dysarthria-ataxia (PDA) syndrome. These episodic symptoms in MS are not well documented and the clinical-radiological correlation is poorly studied [1][2][3][4][5]. Here we report two patients with clinically definite MS who presented with PD and PDA syndromes, respectively, and the associated findings of MRI.…”

Section: Introductionmentioning

confidence: 97%

Paroxysmal dysarthria and ataxia in multiple sclerosis and corresponding magnetic resonance imaging findings

Zeng

Luo

2010

J Neurol

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Paroxysmal dysarthria (PD) and paroxysmal dysarthria-ataxia (PDA) syndromes are uncommon symptoms of the neurological dysfunction in multiple sclerosis (MS). We describe two patients who had clinically definite MS presented with symptomatic PD and PDA syndromes, respectively, related to demyelinating lesions. In one patient, the PD symptom was the initial manifestation of an acute episode. In the other patient, the episode of dysarthria was accompanied by ataxia disorders. Both patients had midbrain lesions at or below the level of the right red nucleus on magnetic resonance imaging (MRI), confirming that this area is critically involved. Both responded well to carbamazepine (CBZ).

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Section: Introductionmentioning

confidence: 97%

Paroxysmal dysarthria and ataxia in multiple sclerosis and corresponding magnetic resonance imaging findings

Zeng

Luo

2010

J Neurol

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“…In a review of the available English medical literature, we identified 6 reports since 1980, representing a total of 10 cases. 4,5,[17][18][19][20] Of these patients, 8 had lesions in the midbrain, 1 had a lesion in a cerebellar hemisphere, and 1 had multiple lesions involving the midbrain, pons, and cerebellar hemispheres. In addition to the reports of paroxysmal dysarthria and ataxia in patients with MS, there is one reported case occurring in a patient with neuro-Behçet disease.…”

Section: 4-6mentioning

confidence: 99%

“…Doses of carbamazepine ranging from 200 to 800 mg/day have been reported to be effective. 4,5,15,[17][18][19]21 Alternative medications of benefit include phenytoin, lamotrigine, and acetazolamide. 15,19,20 Ibuprofen and bromocriptine have been used to treat other paroxysmal symptoms in MS, but not specifically paroxysmal dysarthria and ataxia, to our knowledge.…”

Section: 4-6mentioning

confidence: 99%

Harry Lee Parker and paroxysmal dysarthria and ataxia

et al. 2013

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Objective: To review descriptions of paroxysmal dysarthria and ataxia in multiple sclerosis (MS), with special attention given to Parker and his 1946 case series.Methods: Evaluation of original publications describing paroxysmal dysarthria and ataxia, bibliographic information, writings, and unpublished letters from the Mayo Clinic Historical Unit.Results: In 1940, Störring described a patient with MS with paroxysmal symptoms that included dizziness and trouble speaking, but also unilateral extremity weakness. In 1946, Parker published a series of 11 patients with paroxysmal dysarthria and ataxia. Six of these patients had MS, and he recognized this phenomenon as a manifestation of the disease. The term "paroxysmal dysarthria and ataxia" was first used in 1959 by Andermann and colleagues. Since that time, paroxysmal dysarthria and ataxia has become a well-recognized phenomenon in MS. More recent reports have suggested that the responsible lesion is located in the midbrain, near or involving the red nucleus. Paroxysmal motor and sensory phenomena are well-described complications of multiple sclerosis (MS). These stereotyped events are of sudden onset and brief duration, and can occur multiple times an hour. Paroxysmal symptoms that have been reported include diplopia, trigeminal neuralgia, facial paresthesia, pain, itching, tonic seizures, akinesia, and dysarthria and ataxia. [1][2][3] There is disagreement about who first described paroxysmal dysarthria and ataxia in MS, with some authors giving priority to Gustav Störring and others to Harry Lee Parker. Conclusions:2,4-7 Parker (figure) described patients with attacks of dysarthria and ataxia in 1946. Since then, paroxysmal dysarthria and ataxia has become a well-known phenomenon in MS, appearing in numerous neurology and MS textbooks. 1,2OBJECTIVE The objective of the study was to review the earliest descriptions of paroxysmal dysarthria and ataxia and its association with MS. Particular attention was given to Parker and his 1946 case series. The authors compared these early descriptions to subsequent case reports.METHODS The authors evaluated original publications describing paroxysmal dysarthria and ataxia in patients with MS, as well as bibliographic information, writings, and unpublished letters from the Mayo Clinic Historical Unit pertaining to Harry Lee Parker. The Harry Lee Parker Collection in the Mayo Clinic Historical Unit contains a quarter foot of material. PubMed was searched using the search term "paroxysmal dysarthria and ataxia" to identify more recent case reports and case series.

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“…The attacks usually last few seconds, and may occur many times during the day. This condition has been anecdotally reported in multiple sclerosis (MS) and in other neurologic diseases [1,4,5]. Carbamazepine has been described to be effective [4].…”

mentioning

confidence: 97%

“…Few reports suggest the effectiveness of carbamazepine [4], lamotrigine [9], acetazolamide [10], phenytoin [6] and oxcarbazepine [5].…”

mentioning

confidence: 99%