Contributions
Abstract: P897
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background: Paroxysmal tonic spasms, also known as tonic seizures or paroxysmal dystonia, can be an atypical presenting or complicating feature of multiple sclerosis (MS). They entail sudden, stereotyped episodes of abnormal posture. They are often brief, occurring many times a day, either spontaneously or provoked by movement, touch, or other maneuvers. We describe five such patients, all of whom had a demyelinating lesion in the contralateral corticospinal tract in the posterior limb of the internal capsule.
Objective: To present a case series of five patients with MS who experienced tonic spasms and their localisation.
Methods: Chart review and literature search.
Results: Five cases of tonic spasms in MS with correlating corticospinal tract lesions:
Case 1: A 29-year-old female presented with cramping in her right arm and leg with abnormal posturing of the hand and foot with clenching and overlapping of digits.
Case 2: A 30-year-old female with frequent episodes of right arm and leg dystonic movements with fanning of the fingers and toes.
Case 3: A 39-year-old male with left facial twitching and spams of the left hand elicited by yawning.
Case 4: A 29-year-old female with MS with involuntary clenching of the left hand.
Case 5: A 34-year-old female with tingling of the right arm and leg followed by involuntary flexion of the right wrist and fingers.
In all cases, a brain MRI showed a demyelinating lesion in the contralateral corticospinal tract in the posterior limb of the internal capsule, as well as other lesions consistent with MS.
Conclusions: Tonic spasms in MS can be localised to the contralateral posterior limb of the internal capsule. While non-epileptic in origin, they often respond to anti-epileptic drugs. Prompt recognition of this phenomenon can expedite work up and facilitate treatment.
Disclosure: Dr. Josef Gutman: Nothing to disclose.
Dr. Danielle Stember: Nothing to disclose
Dr. Jonathan Howard: Nothing to disclose
Abstract: P897
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background: Paroxysmal tonic spasms, also known as tonic seizures or paroxysmal dystonia, can be an atypical presenting or complicating feature of multiple sclerosis (MS). They entail sudden, stereotyped episodes of abnormal posture. They are often brief, occurring many times a day, either spontaneously or provoked by movement, touch, or other maneuvers. We describe five such patients, all of whom had a demyelinating lesion in the contralateral corticospinal tract in the posterior limb of the internal capsule.
Objective: To present a case series of five patients with MS who experienced tonic spasms and their localisation.
Methods: Chart review and literature search.
Results: Five cases of tonic spasms in MS with correlating corticospinal tract lesions:
Case 1: A 29-year-old female presented with cramping in her right arm and leg with abnormal posturing of the hand and foot with clenching and overlapping of digits.
Case 2: A 30-year-old female with frequent episodes of right arm and leg dystonic movements with fanning of the fingers and toes.
Case 3: A 39-year-old male with left facial twitching and spams of the left hand elicited by yawning.
Case 4: A 29-year-old female with MS with involuntary clenching of the left hand.
Case 5: A 34-year-old female with tingling of the right arm and leg followed by involuntary flexion of the right wrist and fingers.
In all cases, a brain MRI showed a demyelinating lesion in the contralateral corticospinal tract in the posterior limb of the internal capsule, as well as other lesions consistent with MS.
Conclusions: Tonic spasms in MS can be localised to the contralateral posterior limb of the internal capsule. While non-epileptic in origin, they often respond to anti-epileptic drugs. Prompt recognition of this phenomenon can expedite work up and facilitate treatment.
Disclosure: Dr. Josef Gutman: Nothing to disclose.
Dr. Danielle Stember: Nothing to disclose
Dr. Jonathan Howard: Nothing to disclose