Paroxysmal attacks are short, frequent and stereotyped symptoms that can be observed in various clinical conditions. They are usually associated with Multiple Sclerosis, but they may also be observed in other disorders such as encephalitis, head trauma, stroke and Behçet's disease.
Paroxysmal attacks in various disorders have been reported extensively and ephaptic transmission of demyelinatednerves has been presumed as one of the underlying mechanisms of this phenomenon. Exercise, tactile stimuli, hot water, anxiety and neck flexion may provoke paroxysmal attacks. Mostly reported paroxysmal attacks are painful tonic spasmsdysarthria and ataxia, numbness and hemiparesis. They are typically different from other transient symptoms by their brevity (lasting no more than 2 minutes), frequency (from 1-2 times/day up to a few hundred times/day), stereotyped fashion and excellent response to drugs (usually carbamazepine). Withdrawal of symptoms without any residual neurological finding is another key feature in their recognition.
Paroxysmal hemicrania is a rare form of headache that usually begins in adulthood.
Attacks of paroxysmal hemicrania typically occur from 5 to 40 times per day and last 2 to 45 minutes.
Patients with both paroxysmal hemicrania and trigeminal neuralgia (a condition of the 5th cranial nerve that causes sudden, severe pain typically felt on one side of the jaw or cheek) should receive treatment for each disorder.
Paroxysmalattacks in various disorders have been reported extensively and ephaptic transmission of demyelinated nerves has been presumed as one of the underlying mechanisms of this phenomenon.
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