Everyone’s experience of MS is different, and while paroxysmal symptoms are not common, if left untreated they can seriously affect health and mental wellbeing.
By understanding what triggers your paroxysmal symptoms, a healthcare professional can work with you to develop a treatment management strategy that helps reduce their impact and support your quality of life.
What are the paroxysmal symptoms of MS?
The term paroxysmal describes symptoms that occur suddenly, are short in duration, and often intense. Paroxysmal can describe a number of medical, physical or psychological symptoms. In multiple sclerosis, paroxysmal describes any symptom that occurs in a pattern, comes on suddenly, lasts anywhere from seconds to weeks, and then resolves or disappears.
Other terms for paroxysmal symptoms include intermittent, zaps, clusters, or episodic symptoms. Research suggests that paroxysmal symptoms occur in 1.6% to 17% of people with MS.
Common types of paroxysmal symptoms include:
Trigeminal neuralgia: sharp, shooting or stabbing pain down one side of the face, often the lower face and jaw.
Lhermitte’s sign: a sudden tingling or electric shock-like sensation down the neck and spine, often triggered by bending the head forwards.
Neuropathic (nerve) pain: brief, shooting pains in the arms or legs that can be intense but brief.
Sensory symptoms: itching, numbness, tingling or burning sensations of the skin – sometimes feeling like ants crawling on or under the skin.
Spasms: sudden twitching or tightening of arms, legs, face or trunk, sometimes causing the hand to 'claw.'
Less common paroxysmal symptoms may include pelvic pain, urinary incontinence spasms, eye spams, visually evoked nausea and vomiting, hiccups, vertigo, slurred speech (dysarthria) and balance symptoms.
Do MS symptoms come and go?
Yes, MS symptoms, especially paroxysmal symptoms, can come and go. In MS, paroxysmal symptoms are thought to be related to inappropriate electrical signals that occur in already damaged nerves, although other potential causes should be investigated. Generally, the symptoms will only last for a few weeks to months.
How long do paroxysmal symptoms last?
A paroxysm typically lasts for a few seconds or a few minutes. These paroxysmal episodes can be painful or annoying and disrupt your everyday activities, but are generally temporary.
What causes paroxysmal symptoms?
Paroxysmal symptoms have common triggers including:
- Movement
- Touch (for example, brushing teeth can trigger trigeminal neuralgia)
- Stress
- Heat, cold or temperature changes
- Fatigue
- Hyperventilation (breathing too quickly)
If you experience repeated or worsening paroxysmal symptoms, speak with an MS Nurse Advisor for advice and support. Contact us today on 1800 042 138 or connect@msplus.org.au.
Support managing MS symptoms
Managing paroxysmal symptoms depends on how much they interfere with your daily life. Because these symptoms are brief and unpredictable, treatment often requires a tailored, multidisciplinary approach.
Helpful management strategies include:
- Identifying and avoiding known triggers
- Keeping a symptom diary to track episodes of paroxysmal symptoms
- Ensuring adequate rest, hydration and stress management
Medication and treatment options
Some medications can help relieve the symptoms that cause pain and uncomfortable sensations, including antiepileptic drugs, muscle relaxants, antidepressants and cardiac medications.
Other interventions may include nerve blocks, surgical interventions and pain-relieving devices such as transcutaneous electrical nerve stimulation (TENS).
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 for people living with MS.
Each person’s experience of 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 suspect a relapse, contact your MS nurse or neurologist as soon as possible.