Download PDF
Aktuelle Neurologie 2001; 28(5): 214-218
DOI: 10.1055/s-2001-14444
ÜBERSICHT
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Paroxysmale Phänomene bei multipler Sklerose

Paroxysmal Phenomena in Multiple SclerosisJ. Kesselring
  • Chefarzt Neurologie, Rehabilitationszentrum, Valens, Schweiz
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Paroxysmale Phänomene sind nicht so seltene und recht typische klinische Manifestationen der multiplen Sklerose. Diese Sekunden oder wenige Minuten dauernden Ausfalls- oder Reizerscheinungen von Seiten verschiedener Bereiche im ZNS lassen sich am ehesten durch ephaptische Impulsübertragung infolge myelino-axonaler Dissoziation innerhalb der MS-Plaque erklären. Sie sollten deshalb erkannt werden, weil sie auch bereits als Initialsymptome der Krankheit vorkommen können, für die Betroffenen sehr unangenehm sind und oft auf eine Behandlung mit Antiepileptika gut ansprechen.

Paroxysmal Phenomena in Multiple Sclerosis

Paroxysmal phenomena are rare but relatively typical clinical symptoms of multiple sclerosis which may occasionally occur as initial manifestation of the disease. Such shortlived clinical symptoms and signs are probably caused by ephaptic impulse transmission due to myelino-axonal dissociation within the demyelinated plaque. They should be recognized since they can serve as clinical indicators of the disease and can be treated efficiently with antiepileptic drugs.

Literatur

  • 1 Kesselring J. Multiple Sklerose, 4. Auflage. Stuttgart; Kohlhammer Verlag 2001
    Search in Google Scholar
  • 2 Uhthoff W. Untersuchungen über die bei der multiplen Herdsklerose vorkommenden Augenstörungen.  Arch Psychiat Nervenkrankh. 1890;  21 55-116, 303 - 410
    PubMedSearch in Google Scholar
  • 3 Davis F A, Schauf C L. Pathophysiology of multiple sclerosis. In: Davison AN et al (eds) Multiple sclerosis research. Amsterdam; Elsevier 1975: 102-131
    Search in Google Scholar
  • 4 McDonald W I, Compston D AS, Edan G. et al .Diagnostic Criteria for MS: Guidelines from the International Panel on the Diagnosis of MS. Ann Neurol 2001 (im Druck)
    Search in Google Scholar
  • 5 Leube W. Über multiple inselförmige Sklerose des Gehirns und des Rückenmarkes.  Dtsch Arch klin Med. 1871;  8 1-27
    PubMedSearch in Google Scholar
  • 6 Boudin P, Masson S, Vacheron-Haglin F. et al . Electro-clinical study of 187 cases of disseminated sclerosis, 11 with clinical signs of epilepsy.  EEG Clin Neurophysiol. 1966;  20 209
    PubMedSearch in Google Scholar
  • 7 Trouillas P, Courjon J. Epilepsy with multiple sclerosis.  Epilepsia. 1972;  13 325-333
    PubMedSearch in Google Scholar
  • 8 Engelsen B A, Gronning M. Epileptic seizures in patients with multiple sclerosis. Is the prognosis of epilepsy underestimated?.  Seizure. 1997;  6 377-382
    CrossrefPubMedSearch in Google Scholar
  • 9 Moreau T, Sochurkova D, Lemesle M. et al . Epilepsy in patients with multiple sclerosis: radiological-clinical correlations.  Epilepsia. 1998;  39 839-896
    PubMedSearch in Google Scholar
  • 10 Kinnunen E, Wikstrom J. Prevalence and prognosis of epilepsy in patients with multiple sclerosis.  Epilepsia. 1986;  27 729-733
    PubMedSearch in Google Scholar
  • 11 Olafsson E, Benedicz J, Hauser W A. Risk of epilepsy in patients with multiple sclerosis: a population-based study in Iceland.  Epilepsia. 1999;  40 745-747
    CrossrefPubMedSearch in Google Scholar
  • 12 Kesselring J. Paroxysmale Phänomene bei der multiplen Sklerose.  Schweiz Med Wschr. 1985;  115 1954-1059
    PubMedSearch in Google Scholar
  • 13 Janz D. Die Epilepsien, 2. Auflage. Stuttgart; Thieme Verlag 1998
    Search in Google Scholar
  • 14 Drake W E, Macrae D. Epilepsy in multiple sclerosis.  Neurology. 1961;  11 810-819
    PubMedSearch in Google Scholar
  • 15 Thompson A J, Kermode A G, Moseley I F. et al . Seizures due to multiple sclerosis: seven patients with MRI correlations.  J Neurol Neurosurg Psychiatry. 1993;  56 1317-1320
    CrossrefPubMedSearch in Google Scholar
  • 16 Truyen L, Barkhof F, Frequin S T. et al . Magnetic resonance imaging of epilepsy in multiple sclerosis: a case-control study. Implications for treatment trials with 4-Aminopyridine.  Mult Scler. 1996;  1 213-217
    PubMedSearch in Google Scholar
  • 17 Murillo M J, Alardo Y, Mompeo B. et al . Crise épiléptique et sclérose enplaques: corrélation anatomo-clinique.  Rev Neurol (Paris). 1999;  29 508-510
    PubMedSearch in Google Scholar
  • 18 Brownell B, Hughes J T. Distribution of plaques in the cerebrum in multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1962;  25 315-320
    CrossrefPubMedSearch in Google Scholar
  • 19 Miller D H, Kesselring J, McDonald W I. et al .Magnetresonanz bei multipler Sklerose. Stuttgart; Kohlhammer Verlag 1998
    Search in Google Scholar
  • 20 Quandt J. Multiple Sklerose und Epilepsie. Ein neuropathologischer Beitrag.  Arch Psychiat ges Neurol. 1957;  195 424-434
    PubMedSearch in Google Scholar
  • 21 Smith B J, Elsevich K. Surgical treatment of intractable epilepsy attributable to multiple sclerosis.  Neurology. 1998;  51 606-608
    PubMedSearch in Google Scholar
  • 22 Gass A, Kitchen N, MacManus D G. et al . Trigeminal neuralgia in patients with multiple sclerosis: lesion localization with magnetic resonance imaging.  Neurology. 1997;  49 1142-1144
    CrossrefPubMedSearch in Google Scholar
  • 23 Crooks D A, Miles J B. Trigeminal neuralgia due to vascular compression in multiple sclerosis - post mortem findings.  Br J Neurosurg. 1996;  10 85-88
    CrossrefPubMedSearch in Google Scholar
  • 24 Meaney J F, Watt J W, Eldridge P R. et al . Association between trigeminal neuralgia and multiple sclerosis: role of magnetic resonance imaging.  J Neurol Neurosurg Psychiatry. 1995;  59 253-259
    PubMedSearch in Google Scholar
  • 25 Hooge J P, Redekop W K. Trigeminal neuralgia in multiple sclerosis.  Neurology. 1995;  45 1294-1296
    CrossrefPubMedSearch in Google Scholar
  • 26 Matthews W B. Tonic seizures in disseminated sclerosis.  Brain. 1958;  81 193-206
    PubMedSearch in Google Scholar
  • 27 Castaigne P, Cambier J, Masson M. et al . Les manifestations motrices paroxystiques de la sclérose en plaques.  Presse méd. 1970;  78 1921-1924
    PubMedSearch in Google Scholar
  • 28 Perks W H, Lascelle R G. Paroxysmal brain stern dysfunction as presenting feature of multiple sclerosis.  Br med J. 1976;  II 1175-1176
    PubMedSearch in Google Scholar
  • 29 Shibasaki H, Kuroiwa Y. Painful tonic seizures in multiple sclerosis.  Arch Neurol. 1974;  30 47-51
    PubMedSearch in Google Scholar
  • 30 Toyokura Y, Sakuta M, Nakanishi T. Painful tonic seizures in multiple sclerosis.  Neurology. 1976;  26 18-19
    PubMedSearch in Google Scholar
  • 31 Matthews W B. Symptoms and signs of multiple sclerosis. In: Compston A, Ebers G, Matthews B et al (eds) McAlpine's Multiple Sclerosis. 3rd edition. Edinburgh; Churchill Livingston 1998: 145-190
    Search in Google Scholar
  • 32 Demirkian M, Jankovic J. Paroxysmal dyskinesias: clinical features and classification.  Ann Neurol. 1995;  38 571-679
    CrossrefPubMedSearch in Google Scholar
  • 33 Bathia K P. The paroxysmal dyskinesias.  J Neurol. 1999;  246 149-155
    PubMedSearch in Google Scholar
  • 34 Twomey J A, Espir M LE. Paroxysmal symptoms as the first manifestation of multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1980;  43 296-304
    PubMedSearch in Google Scholar
  • 35 Watson C P, Chiu M. Painful tonic seizures in multiple sclerosis: localisation of a lesion.  J Canad Sci Neurol. 1979;  6 359-361
    PubMedSearch in Google Scholar
  • 36 Sozzi G, Marotta P, Piatti L. et al . Paroxysmal sensory-motor attacks due to a spinal cord lesion identified by MRI.  J Neurol Neurosurg Psychiatry. 1987;  50 490-492
    PubMedSearch in Google Scholar
  • 37 Burguera J A, Català J, Casanova B. Thalamic demyelination and paroxysmal dystonia in multiple sclerosis.  Mov Dis. 1991;  6 379-381
    PubMedSearch in Google Scholar
  • 38 Lugaresi A, Uncini A, Gambi D. Basal ganglia involvement in multiple sclerosis with alternating side paroxysmal dystonia.  J Neurol. 1993;  240 257-258
    PubMedSearch in Google Scholar
  • 39 Wilson S AK, McBride H J. Epilepsy as a symptom of disseminated sclerosis.  J Neurol Psychopath. 1925;  6 91
    PubMedSearch in Google Scholar
  • 40 Smith K J, McDonald W I. The pathophysiology of multiple sclerosis: the mechanisms underlying the production of symptoms and the natural history f the disease.  Phil Trans R Soc Lond B Biol Sci. 1999;  354 1649-1673
    PubMedSearch in Google Scholar
  • 41 Maimon D, Reder A T, Finocchiaro F. et al . Internal capsule plaque and tonic spasms in multiple sclerosis.  Arch Neurol. 1991;  48 427-429
    PubMedSearch in Google Scholar
  • 42 Ekbom K A, Westerberg C E, Osterman P O. Focal sensory motor seizures of spinal origin.  Lancet. 1966;  I 67
    PubMedSearch in Google Scholar
  • 43 Lhermitte J, Bollack J, Nicolas M. Les douleurs à type de décharge électrique consécutives à la flexion céphalique dans la sclérose en plaques: un cas de forme sensitive de la sclerose multiple.  Rev Neurol (Paris). 1924;  2 56-62
    PubMedSearch in Google Scholar
  • 44 Babinski J, Dubois R. Douleurs à forme de décharge électrique consécutives aux traumatismes de la nuque.  Presse méd. 1918;  26 64
    PubMedSearch in Google Scholar
  • 45 Kanchandani R, Howe J G. Lhermitte's sign in multiple sclerosis. A clinical survey and review of the literature.  J Neurol Neurosurg Psychiatry. 1982;  45 308-312
    PubMedSearch in Google Scholar
  • 46 Gautier-Smith P C. Lhermitte's sign in subacute combined degeneration of the cord.  J Neurol Neurosurg Psychiatry. 1973;  36 861-863
    PubMedSearch in Google Scholar
  • 47 Godwin-Austen R H, Howell D A, Worthington H. Observations on radiation myelopathy.  Brain. 1975;  98 557-568
    PubMedSearch in Google Scholar
  • 48 Smith K J, McDonald W I. Spontaneous and mechanically evoked activity due to central demyelinating lesion.  Nature. 1980;  286 154-155
    CrossrefPubMedSearch in Google Scholar
  • 49 Wolf P, Assmus H. Paroxysmale Dysarthrie und Ataxie.  J Neurol. 1974;  208 27-38
    CrossrefPubMedSearch in Google Scholar
  • 50 Osterman P O, Westerberg C E. Paroxysmal attacks in multiple sclerosis.  Brain. 1975;  98 189-202
    PubMedSearch in Google Scholar
  • 51 Berger J R, Sheremata W A, Mekamed E. Paroxysmal dystonia as the initial manifestation of multiple sclerosis.  Arch Neurol. 1984;  41 747-750
    CrossrefPubMedSearch in Google Scholar
  • 52 McFarling O A, Susac J O. „Hoquet diabolique”: intractable hiccup as a manifestation of multiple sclerosis.  Neurology. 1979;  29 797-801
    PubMedSearch in Google Scholar
  • 53 Osterman P O. Paroxysmal itching in multiple sclerosis.  Brit J Derm. 1976;  95 555-558
    PubMedSearch in Google Scholar
  • 54 Koeppel M C, Bramont C, Ceccaldi M. et al . Paroxysmal pruritus and multiple sclerosis.  Br J Dermatol. 1993;  129 597-598
    PubMedSearch in Google Scholar
  • 55 Moulin D E, Foley K M, Ebers G C. Pain syndromes in multiple sclerosis.  Neurology. 1988;  38 1830-1834
    CrossrefPubMedSearch in Google Scholar
  • 56 Vaney C. Schmerzen bei multipler Sklerose. Klinik und Therapie.  Schweiz Med Wschr. 1990;  120 1959-1964
    PubMedSearch in Google Scholar
  • 57 Postert T, McMonagle U, Buttner T. et al . Paroxysmal convergence spasm in multiple sclerosis.  Acta Neurol Scand. 1996;  94 35-37
    PubMedSearch in Google Scholar
  • 58 Ezra E, Plant G T. Paroxysmal superior rectus and levator palpebrae spasm: a unique presentation of multiple sclerosis.  Br J Ophthalmol. 1996;  80 187-188
    PubMedSearch in Google Scholar
  • 59 Bronstein A M. Visually induced paroxysmal nausea and vomiting as presenting manifestation of multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1996;  60 703
    PubMedSearch in Google Scholar
  • 60 Espir M LE, Millac P. Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine (Tegretol).  J Neurol Neurosurg Psychiatry. 1970;  33 528-531
    PubMedSearch in Google Scholar
  • 61 Solaro C, Lunardi G L, Capello E. et al . An open-label trial of gabapentin treatment of paroxysmal symptoms in multiple sclerosis patients.  Neurology. 1998;  51 609-611
    PubMedSearch in Google Scholar

Prof. Jürg Kesselring

Chefarzt Neurologie
Rehabilitationszentrum

7317 Valens
Schweiz

Email: kesselring.klival@spin.ch