Paroxysmal attacks
Encyclopedia
Paroxysmal attacks are short, frequent and stereotyped symptom
s that can be observed in various clinical conditions. They are usually associated with multiple sclerosis
, pertussis
, but they may also be observed in other disorder
s such as encephalitis
, head trauma
, stroke
, asthma
, trigeminal neuralgia
, breath-holding spells
, epilepsy
, malaria
, tabes dorsalis
, and Behçet's disease
. It has also been noted as a symptom of Gratification disorder
in children.
Paroxysmal attacks in various disorders have been reported extensively and ephaptic coupling
of myelin nerve has been presumed as one of the underlying mechanisms of this phenomenon. This is supported by the presence of these attacks in multiple sclerosis and tabes dorsalis, which both involve demyelination of spinal cord neurons. Exercise, tactile stimuli, hot water, anxiety and neck flexion may provoke paroxysmal attacks. Mostly reported paroxysmal attacks are painful tonic spasm
s dysarthria
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.
The word paroxysm means sudden fit or outburst.
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s that can be observed in various clinical conditions. They are usually associated with multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
, pertussis
Pertussis
Pertussis, also known as whooping cough , is a highly contagious bacterial disease caused by Bordetella pertussis. Symptoms are initially mild, and then develop into severe coughing fits, which produce the namesake high-pitched "whoop" sound in infected babies and children when they inhale air...
, but they may also be observed in other disorder
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
s such as encephalitis
Encephalitis
Encephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningoencephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue...
, head trauma
Physical trauma
Trauma refers to "a body wound or shock produced by sudden physical injury, as from violence or accident." It can also be described as "a physical wound or injury, such as a fracture or blow." Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death...
, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
, trigeminal neuralgia
Trigeminal neuralgia
Trigeminal neuralgia , tic douloureux is a neuropathic disorder characterized by episodes of intense pain in the face, originating from the trigeminal nerve. It has been described as among the most painful conditions known...
, breath-holding spells
Breath-holding spells
Breath holding spells are the occurrence of episodic apnea in children, possibly associated with loss of consciousness, and changes in postural tone....
, epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
, malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
, tabes dorsalis
Tabes dorsalis
Tabes dorsalis is a slow degeneration of the sensory neurons that carry afferent information. The degenerating nerves are in the dorsal columns of the spinal cord and carry information that help maintain a person's sense of position , vibration, and discriminative touch.-Cause:Tabes dorsalis is...
, and Behçet's disease
Behçet's disease
Behçet's disease is a rare immune-mediated systemic vasculitis that often presents with mucous membrane ulceration and ocular involvements...
. It has also been noted as a symptom of Gratification disorder
Gratification disorder
Gratification disorder is a form of masturbatory behavior that has often been mistaken for epilepsy, abdominal pain, and paroxysmal dystonia or dyskinesia. Little research has been published regarding this early childhood condition...
in children.
Paroxysmal attacks in various disorders have been reported extensively and ephaptic coupling
Ephaptic coupling
Ephaptic coupling is indirect communication within the nervous system through extracellular electric fields, as opposed to direct communication via electrical synapses or chemical synapses. Ephaptic communication has been observed in myelinated nerve fibers....
of myelin nerve has been presumed as one of the underlying mechanisms of this phenomenon. This is supported by the presence of these attacks in multiple sclerosis and tabes dorsalis, which both involve demyelination of spinal cord neurons. Exercise, tactile stimuli, hot water, anxiety and neck flexion may provoke paroxysmal attacks. Mostly reported paroxysmal attacks are painful tonic spasm
Spasm
In medicine a spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. It is sometimes accompanied by a sudden burst of pain, but is usually harmless and ceases after a few minutes...
s dysarthria
Dysarthria
Dysarthria is a motor speech disorder resulting from neurological injury of the motor component of the motor-speech system and is characterized by poor articulation of phonemes...
and ataxia
Ataxia
Ataxia is a neurological sign and symptom that consists of gross lack of coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum...
, numbness and hemiparesis
Hemiparesis
Hemiparesis is weakness on one side of the body. It is less severe than hemiplegia - the total paralysis of the arm, leg, and trunk on one side of the body. Thus, the patient can move the impaired side of his body, but with reduced muscular strength....
. 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
Carbamazepine
Carbamazepine is an anticonvulsant and mood-stabilizing drug used primarily in the treatment of epilepsy and bipolar disorder, as well as trigeminal neuralgia...
). Withdrawal of symptoms without any residual neurological finding is another key feature in their recognition.
The word paroxysm means sudden fit or outburst.
See also
- ConvulsionConvulsionA convulsion is a medical condition where body muscles contract and relax rapidly and repeatedly, resulting in an uncontrolled shaking of the body. Because a convulsion is often a symptom of an epileptic seizure, the term convulsion is sometimes used as a synonym for seizure...
- RelapseRelapseRelapse, in relation to drug misuse, is resuming the use of a drug or a dependent substance after one or more periods of abstinence. The term is a landmark feature of both substance dependence and substance abuse, which are learned behaviors, and is maintained by neuronal adaptations that mediate...
or remission, where symptoms become worse or better