MS Paroxysmal Symptoms

Reviewed by: HU Medical Review Board | Last reviewed: February 2024

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system. People with MS may experience periods of symptoms that last for days, weeks, or even months. These may be part of an MS flare or relapse.1,2

But some chronic issues related to MS can cause short bursts of intense symptoms called paroxysmal symptoms. Paroxysmal symptoms involve unusual sensations or muscle contractions. Around 3 in every 100 people with MS experienced paroxysmal symptoms. They tend to occur in earlier stages of the disease.1-3

Paroxysmal symptoms usually last for just seconds or minutes, but they can occur multiple times a day. You may also have periods when they happen more often. And while paroxysmal symptoms do not last as long as other typical MS symptoms, dealing with them can still be a challenge.1,2

What are paroxysmal symptoms of MS?

Paroxysmal symptoms usually have a sudden onset and last only for a short time. These symptoms can involve many different systems in the body. They can be triggered by:1,2

  • Fatigue
  • Temperature changes
  • Emotional changes
  • Certain sensations (like touch)
  • Hyperventilation (breathing too quickly or deeply)
  • A sudden shift in body position

Common paroxysmal symptoms include:1,2

  • Motor symptoms – Muscle contractions or spasms, weakness, or a feeling of “heavy” limbs
  • Sensory symptoms – Burning, tingling, loss of sensation or feeling, tickling, or pain
  • Autonomic symptoms (involving the “rest and digest” system) – Coughing, dizziness, trouble swallowing, slurred speech, nausea or vomiting, hiccups, or urinary leakage (incontinence)
  • Some people also experience an electric shock-like feeling around the face and head (trigeminal neuralgia) or down the neck and spine (Lhermitte’s sign).1,2,4

    What causes paroxysmal symptoms?

    The reason paroxysmal symptoms happen is not well understood, but experts have a few ideas. MS causes issues with myelin, the protective coating that helps nerves carry signals quickly between parts of the body or brain. Damage to myelin is called demyelination.1

    Demyelination may cause nerve cells to act abnormally, firing signals when they should be at rest. These nerve cells also may be more sensitive to symptom triggers, also making them fire abnormally. Nerve cells all over the body can be damaged by MS, which may explain the wide range of paroxysmal symptoms that people can experience.1-3

    Paroxysmal symptom management and treatment

    Paroxysmal symptoms can be alarming, and they are easily misdiagnosed. But they usually resolve on their own, making treatment unnecessary. If they affect daily life and functioning, paroxysmal symptoms can be treated.2

    The first line of defense against paroxysmal symptoms is to avoid any known triggers. This could mean:2

    • Not moving your body in a certain way
    • Keeping consistently warm or cool
    • Getting enough sleep
    • Taking care of your emotional health

    These kinds of symptoms can be stressful, as they can come on without warning. Mindfulness techniques that keep you grounded in the present may help ease some of the stress around symptoms.2

    Treatment for paroxysmal symptoms often includes anti-epileptic drugs. Paroxysmal symptoms are sometimes misdiagnosed as seizures. Though these conditions are different, anti-epileptic drugs can help with issues in nerve cell firing caused by paroxysmal symptoms in some cases.1,2

    Paroxysmal symptoms do not usually mean that an MS relapse is coming. But if symptoms persist or you think you may be having a relapse, let your doctor or neurologist know. They may be able to treat any symptoms that are interfering with your daily life.2

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