Paroxysmal attacks or paroxysms are a sudden recurrence or intensification of
symptom
Signs and symptoms are diagnostic indications of an illness, injury, or condition.
Signs are objective and externally observable; symptoms are a person's reported subjective experiences.
A sign for example may be a higher or lower temperature ...
s, such as a
spasm
A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ, such as the bladder.
A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a musc ...
or
seizure
A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, o ...
. These short, frequent symptoms can be observed in various clinical conditions. They are usually associated with
multiple sclerosis
Multiple sclerosis (MS) is an autoimmune disease resulting in damage to myelinthe insulating covers of nerve cellsin the brain and spinal cord. As a demyelinating disease, MS disrupts the nervous system's ability to Action potential, transmit ...
or
pertussis
Whooping cough ( or ), also known as pertussis or the 100-day cough, is a highly contagious, vaccine-preventable bacterial disease. Initial symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough, bu ...
, but they may also be observed in other
disorders such as
encephalitis
Encephalitis is inflammation of the Human brain, brain. The severity can be variable with symptoms including reduction or alteration in consciousness, aphasia, headache, fever, confusion, a stiff neck, and vomiting. Complications may include se ...
, head
trauma,
stroke
Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...
,
autism
Autism, also known as autism spectrum disorder (ASD), is a neurodevelopmental disorder characterized by differences or difficulties in social communication and interaction, a preference for predictability and routine, sensory processing d ...
,
asthma
Asthma is a common long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wh ...
,
trigeminal neuralgia
Trigeminal neuralgia (TN or TGN), also called Fothergill disease, tic douloureux, trifacial neuralgia, is a chronic pain, long-term pain disorder that affects the trigeminal nerve, the nerve responsible for sensation in the face and motor funct ...
,
breath-holding spells,
epilepsy
Epilepsy is a group of Non-communicable disease, non-communicable Neurological disorder, neurological disorders characterized by a tendency for recurrent, unprovoked Seizure, seizures. A seizure is a sudden burst of abnormal electrical activit ...
,
malaria
Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...
,
tabes dorsalis
Tabes dorsalis is a late consequence of neurosyphilis, characterized by the slow degeneration (specifically, demyelination) of the neural tracts primarily in the Dorsal root ganglion, dorsal root ganglia of the spinal cord (nerve root). These pati ...
,
Behçet's disease, and
paroxysmal nocturnal hemoglobinuria (PNH). It has also been noted as a symptom of
gratification disorder in children.
The word ''
paroxysm'' means 'sudden attack, outburst' and comes .
παροξυσμός
Henry George Liddell, Robert Scott, ''A Greek-English Lexicon'', on Perseus
Paroxysmal attacks in various disorders have been reported extensively, and ephaptic coupling of demyelinated nerve
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerv ...
s has been presumed as one of the underlying mechanisms of this phenomenon. This is supported by the presence of these attacks in multiple sclerosis and tabes dorsalis, which both involve demyelination of spinal cord neurons. Exercise, tactile stimuli, hot water, anxiety, and neck flexion may provoke paroxysmal attacks. Most reported paroxysmal attacks are painful tonic spasm
A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ, such as the bladder.
A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a musc ...
s, dysarthria
Dysarthria is a speech sound disorder resulting from neurological injury of the motor component of the motor–speech system and is characterized by poor articulation of phonemes. It is a condition in which problems effectively occur with the ...
and ataxia
Ataxia (from Greek α- negative prefix+ -τάξις rder= "lack of order") is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in e ...
, numbness
Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to Sensory receptor, sensory stimuli. In everyday speech this is generally r ...
, and hemiparesis
Hemiparesis, also called unilateral paresis, is the weakness of one entire side of the body (''wikt:hemi-#Prefix, hemi-'' means "half"). Hemiplegia, in its most severe form, is the complete paralysis of one entire side of the body. Either hemipar ...
. They are typically different from other transient symptoms by their brevity (lasting no more than 2 minutes), frequency (from 1–2 times/day up to a few hundred times/day), stereotyped fashion, and excellent response to drugs (usually carbamazepine). Withdrawal of symptoms without any residual neurological finding is another key feature in their recognition.
See also
* BPPV
Benign paroxysmal positional vertigo (BPPV) is a disorder arising from a problem in the inner ear. Symptoms are repeated, brief periods of vertigo (medical), vertigo with movement, characterized by a spinning sensation upon changes in the posit ...
* Convulsion
A convulsion is a medical condition where the body muscles contract and relax rapidly and repeatedly, resulting in uncontrolled shaking. Because epileptic seizures typically include convulsions, the term ''convulsion'' is often used as a synony ...
* Female hysteria
Female hysteria was once a common medical diagnosis for women. It was described as exhibiting a wide array of symptoms, including anxiety, shortness of breath, fainting, nervousness, exaggerated and impulsive sexual desire, insomnia, fluid ret ...
for "hysterical paroxysm"
* Relapse
In internal medicine, relapse or recidivism is a recurrence of a past (typically medical) condition. For example, multiple sclerosis and malaria often exhibit peaks of activity and sometimes very long periods of dormancy, followed by relapse or r ...
or remission, where symptoms become worse or better
References
{{CNS diseases of the nervous system
Neurological disorders