Florczak Jolanta, Kozubski Wojciech
Katedra i Klinika Neurologii AM w Poznaniu.
Neurol Neurochir Pol. 2003;37 Suppl 5:127-31.
Paroxysmal phenomena such as dystonia in multiple sclerosis (MS) have approximate incidence ranged between 3.8%-17%. These symptoms in MS may represent transient phenomena related to inflammation in acute plaques and probably are secondary to irritation of demyelinated axons by lymphokines. Paroxysmal dystonia can occur at any time during the course of MS, but usually is the initial manifestation of demyelinating disease. We present the case of 42-year old woman with paroxysmal dystonia as the initial symptom of MS. Further MRI studies and CSF analysis revealed findings typical for MS. Patient's neurological status improved temporary after methyloprednisolone therapy. Paroxysmal dystonia may be related to ectopic impulses, release of inflammatory soluble factors, dysfunction of ion channels and accumulation of extra-cellular potassium. Paroxysmal dystonia often causes diagnostic difficulties, especially when it is the only or the initial symptom of the disease. It requires differential diagnosis with other diseases of central nervous system such as epilepsy and neurodegenerative or inflammation pathology.
多发性硬化症（MS）中的阵发性现象如肌张力障碍，其发生率约在3.8%至17%之间。MS中的这些症状可能代表与急性斑块炎症相关的短暂现象，可能继发于淋巴细胞因子对脱髓鞘轴突的刺激。阵发性肌张力障碍可在MS病程中的任何时间出现，但通常是脱髓鞘疾病的初始表现。我们报告了一例42岁女性，以阵发性肌张力障碍为MS的初始症状。进一步的MRI研究和脑脊液分析显示出MS的典型表现。患者在接受甲泼尼龙治疗后神经状态暂时改善。阵发性肌张力障碍可能与异位冲动、炎性可溶性因子的释放、离子通道功能障碍和细胞外钾的积累有关。阵发性肌张力障碍常导致诊断困难，尤其是当它是疾病的唯一或初始症状时。它需要与中枢神经系统的其他疾病如癫痫、神经退行性或炎症性病变进行鉴别诊断。
