Objective: To describe the specificities of paroxysmal dystonia (PD) in a cohort of Tunisian Multiple Sclerosis (MS).

Background:

Movements disorders are uncommon in multiple sclerosis. In many instances, movement disorders are presenting features, indicating the importance of these disorders in the early diagnosis of MS. Paroxysmal dystonia is an under-recognized aspect of paroxysmal movement disorders during multiple sclerosis despite being the second most commonly described movement disorder in MS after tremor.

Method: A retrospective , hospital-based study was conducted in the department of Neurology of the Military hospital-Tunisia including patients diagnosed with MS according to 2017 McDonald criteria. This research concerned 100 MS patients and PD was retained if diagnosed during the last 5 years or at time of assessment.

Results: Of the 100 patients diagnosed with MS, paroxysmal dystonia was described among 11 patients. The mean age at onset was 35,64 years. PD was positively correlated with female gender (p = 0.049) and was more frequent among patients diagnosed with secondary progressive MS form (p=0.0039). EDSS score was significantly higher in patients with PD        (p = 0.002) compared to those without PD. Our findings showed correlation between PD and demyelinating lesions in the internal capsule (p=0.001), the thalamus (p=0.001) and the dorsal column of cervical spinal cord (p=0.004). Only 2 patients showed clinical improvement after treatment with carbamazepine.

Conclusion: Paroxysmal Dystonia is a rare and still under-diagnosed feature of multiple sclerosis. This paroxysmal disorder may pose a diagnostic challenge to physicians. A multidisciplinary approach for MS-related PD is necessary in order to improve therapeutic interventions and clinical outcomes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/epidemiological-clinical-and-paraclinical-characteristics-of-paroxysmal-dystonia-in-multiple-sclerosis-a-study-of-tunisian-cohort/