Paroxysmale Phänomene bei multipler Sklerose

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
• 2 Uhthoff W. Untersuchungen über die bei der multiplen Herdsklerose vorkommenden Augenstörungen.  Arch Psychiat Nervenkrankh. 1890;  21 55-116, 303 - 410
• 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
• 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)
• 5 Leube W. Über multiple inselförmige Sklerose des Gehirns und des Rückenmarkes.  Dtsch Arch klin Med. 1871;  8 1-27
• 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
• 7 Trouillas P, Courjon J. Epilepsy with multiple sclerosis.  Epilepsia. 1972;  13 325-333
• 8 Engelsen B A, Gronning M. Epileptic seizures in patients with multiple sclerosis. Is the prognosis of epilepsy underestimated?.  Seizure. 1997;  6 377-382
• 9 Moreau T, Sochurkova D, Lemesle M. et al . Epilepsy in patients with multiple sclerosis: radiological-clinical correlations.  Epilepsia. 1998;  39 839-896
• 10 Kinnunen E, Wikstrom J. Prevalence and prognosis of epilepsy in patients with multiple sclerosis.  Epilepsia. 1986;  27 729-733
• 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
• 12 Kesselring J. Paroxysmale Phänomene bei der multiplen Sklerose.  Schweiz Med Wschr. 1985;  115 1954-1059
• 13 Janz D. Die Epilepsien, 2. Auflage. Stuttgart; Thieme Verlag 1998
• 14 Drake W E, Macrae D. Epilepsy in multiple sclerosis.  Neurology. 1961;  11 810-819
• 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
• 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
• 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
• 18 Brownell B, Hughes J T. Distribution of plaques in the cerebrum in multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1962;  25 315-320
• 19 Miller D H, Kesselring J, McDonald W I. et al .Magnetresonanz bei multipler Sklerose. Stuttgart; Kohlhammer Verlag 1998
• 20 Quandt J. Multiple Sklerose und Epilepsie. Ein neuropathologischer Beitrag.  Arch Psychiat ges Neurol. 1957;  195 424-434
• 21 Smith B J, Elsevich K. Surgical treatment of intractable epilepsy attributable to multiple sclerosis.  Neurology. 1998;  51 606-608
• 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
• 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
• 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
• 25 Hooge J P, Redekop W K. Trigeminal neuralgia in multiple sclerosis.  Neurology. 1995;  45 1294-1296
• 26 Matthews W B. Tonic seizures in disseminated sclerosis.  Brain. 1958;  81 193-206
• 27 Castaigne P, Cambier J, Masson M. et al . Les manifestations motrices paroxystiques de la sclérose en plaques.  Presse méd. 1970;  78 1921-1924
• 28 Perks W H, Lascelle R G. Paroxysmal brain stern dysfunction as presenting feature of multiple sclerosis.  Br med J. 1976;  II 1175-1176
• 29 Shibasaki H, Kuroiwa Y. Painful tonic seizures in multiple sclerosis.  Arch Neurol. 1974;  30 47-51
• 30 Toyokura Y, Sakuta M, Nakanishi T. Painful tonic seizures in multiple sclerosis.  Neurology. 1976;  26 18-19
• 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
• 32 Demirkian M, Jankovic J. Paroxysmal dyskinesias: clinical features and classification.  Ann Neurol. 1995;  38 571-679
• 33 Bathia K P. The paroxysmal dyskinesias.  J Neurol. 1999;  246 149-155
• 34 Twomey J A, Espir M LE. Paroxysmal symptoms as the first manifestation of multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1980;  43 296-304
• 35 Watson C P, Chiu M. Painful tonic seizures in multiple sclerosis: localisation of a lesion.  J Canad Sci Neurol. 1979;  6 359-361
• 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
• 37 Burguera J A, Català J, Casanova B. Thalamic demyelination and paroxysmal dystonia in multiple sclerosis.  Mov Dis. 1991;  6 379-381
• 38 Lugaresi A, Uncini A, Gambi D. Basal ganglia involvement in multiple sclerosis with alternating side paroxysmal dystonia.  J Neurol. 1993;  240 257-258
• 39 Wilson S AK, McBride H J. Epilepsy as a symptom of disseminated sclerosis.  J Neurol Psychopath. 1925;  6 91
• 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
• 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
• 42 Ekbom K A, Westerberg C E, Osterman P O. Focal sensory motor seizures of spinal origin.  Lancet. 1966;  I 67
• 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
• 44 Babinski J, Dubois R. Douleurs à forme de décharge électrique consécutives aux traumatismes de la nuque.  Presse méd. 1918;  26 64
• 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
• 46 Gautier-Smith P C. Lhermitte's sign in subacute combined degeneration of the cord.  J Neurol Neurosurg Psychiatry. 1973;  36 861-863
• 47 Godwin-Austen R H, Howell D A, Worthington H. Observations on radiation myelopathy.  Brain. 1975;  98 557-568
• 48 Smith K J, McDonald W I. Spontaneous and mechanically evoked activity due to central demyelinating lesion.  Nature. 1980;  286 154-155
• 49 Wolf P, Assmus H. Paroxysmale Dysarthrie und Ataxie.  J Neurol. 1974;  208 27-38
• 50 Osterman P O, Westerberg C E. Paroxysmal attacks in multiple sclerosis.  Brain. 1975;  98 189-202
• 51 Berger J R, Sheremata W A, Mekamed E. Paroxysmal dystonia as the initial manifestation of multiple sclerosis.  Arch Neurol. 1984;  41 747-750
• 52 McFarling O A, Susac J O. „Hoquet diabolique”: intractable hiccup as a manifestation of multiple sclerosis.  Neurology. 1979;  29 797-801
• 53 Osterman P O. Paroxysmal itching in multiple sclerosis.  Brit J Derm. 1976;  95 555-558
• 54 Koeppel M C, Bramont C, Ceccaldi M. et al . Paroxysmal pruritus and multiple sclerosis.  Br J Dermatol. 1993;  129 597-598
• 55 Moulin D E, Foley K M, Ebers G C. Pain syndromes in multiple sclerosis.  Neurology. 1988;  38 1830-1834
• 56 Vaney C. Schmerzen bei multipler Sklerose. Klinik und Therapie.  Schweiz Med Wschr. 1990;  120 1959-1964
• 57 Postert T, McMonagle U, Buttner T. et al . Paroxysmal convergence spasm in multiple sclerosis.  Acta Neurol Scand. 1996;  94 35-37
• 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
• 59 Bronstein A M. Visually induced paroxysmal nausea and vomiting as presenting manifestation of multiple sclerosis.  J Neurol Neurosurg Psychiatry. 1996;  60 703
• 60 Espir M LE, Millac P. Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine (Tegretol).  J Neurol Neurosurg Psychiatry. 1970;  33 528-531
• 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