Everyone experiences MS differently, and while paroxysmal symptoms are not common, if left untreated, they can seriously affect your health and mental wellbeing.
By understanding the triggers for different types of paroxysmal symptoms, a healthcare professional can work with you to create a treatment management strategy that helps you find relief and get the most out of life.
Paroxysmal is a term used to describe symptoms that occur suddenly, are of short duration, and often are intense. Paroxysmal is a broad term that can be used to describe a number of medical, physical, or psychological symptoms.
In multiple sclerosis, paroxysmal symptoms describe any symptom that occurs in a pattern where they come on suddenly, last anywhere from seconds to minutes, and then resolve or disappear. Other terms to describe these types of symptoms include intermittent, zaps, clusters, or episodic symptoms. It is estimated that these symptoms occur in 1.6% to 17% of people with MS.
Paroxysmal symptoms in MS are commonly thought to be related to inappropriate electrical signals that occur in nerves that have already been damaged by MS, although there can be a variety of other causes that are important to investigate. Generally, the symptoms can last from a few seconds to a few weeks.
There are several types of paroxysmal symptoms. The more common types are:
trigeminal neuralgia, commonly described as sharp, shooting or stabbing pain down one side of the face, often the lower face and jaw
lhermitte’s sign, which feels like a sudden tingling electrical shock-like sensation down your neck and spine, often when bending your head forwards
neuropathic (nerve) pains such as shooting pains in the arms or legs which are brief but can still be very uncomfortable
sensory symptoms of your skin such as itching, numbness, tingling or burning. Some people have described sensations of feeling like ants are crawling on or under the skin
spasms which may cause the sudden twitching or tightening of arms and legs, or hand clawing. Spasms can also affect the trunk or facial muscles.
Less common paroxysmal symptoms may include pelvic pain, urinary incontinence spasms, eye spams, visually evoked nausea and vomiting, hiccups and vertigo, slurred speech (dysarthria) and balance symptoms.
Paroxysmal symptoms in MS are commonly thought to be related to inappropriate electrical signals that occur in nerves that have already been damaged by MS, although there can be a variety of other causes that are important to investigate. Generally, the symptoms will only last for a few weeks to months.
Paroxysmal symptoms typically last for a few seconds or a few minutes.
These episodes, also known as paroxysmal episodes, can be painful or annoying and disrupt your everyday activities.
Paroxysmal symptoms can be triggered by a number of different things.
Some common triggers people describe include:
touch, such as brushing teeth in the instance of trigeminal neuralgia
stress
hot, cold or temperature changes
fatigue
hyperventilation (breathing too quickly)
Paroxysmal symptoms, or paroxysmal attacks, are due to sudden, inappropriate electrical signals in nerves that have already been damaged by MS.
To help with managing paroxysmal symptoms we recommend speaking with an MS Nurse Advisor. Contact us today on 1800 042 138 or [email protected].
Treatment of paroxysmal symptoms is guided by how much they interfere with your everyday life. Treatment can be complex, as the symptoms may come and go or only last a few months, and it can be difficult to describe.
For people who are aware of the triggers for their paroxysmal symptoms, such as making a particular movement or extreme cold, avoiding the triggers can be a useful strategy. If triggers aren’t clear, keeping a symptom diary can be helpful to track the episodes of paroxysmal symptoms. Simple strategies such as ensuring enough rest, reducing stress and keeping well hydrated can also be helpful.
Some medications can be helpful in relieving the symptoms that cause pain and uncomfortable sensations. There are a range of medications, such as antiepileptic drugs, muscle relaxants, antidepressants, and cardiac medications that are commonly used. Other interventions include nerve blocks, surgical interventions, and pain-relieving devices such as transcutaneous electrical nerve stimulation (TENS).
For many people, a holistic approach that includes a team of nurses, occupational therapists and physiotherapists, speech and language therapists, pain management specialists and mental health supports have been shown to improve outcomes.
Remember that each person’s experience with paroxysmal symptoms is different, so personalised management and regular follow-up with a neurologist is crucial to assess treatment effectiveness and adjust medications as needed.
Paroxysmal symptoms can be a sign of an MS relapse. If you think you may be having a relapse, you should let your MS nurse or neurologist know.
This page has been reviewed and approved by Executive Manager Client Engagement and Wellbeing Jodi Haartsen. Jodi is a registered MS Nurse who has helped thousands of patients over her 20 years’ experience at Eastern Health MS service in Australia, in several roles including nurse educator, research nurse and nurse practitioner. Jodi is the 2022 winner of the global MS Brain Health Leader Award in the Independent Healthcare Professionals category.