A Case of Tonic Spasm Presenting as Sole Manifestation of Multiple Sclerosis

ABSTRACT

A young woman developed a hemilateral tonic spasm associated with multiple sclerosis. Her symptoms included brief recurrent episodes of abnormal, often painful, posturing of one or more extremities without alteration of consciousness. An area of demyelination in the contralateral cerebral peduncle was observed on a magnetic resonance imaging. The tonic attacks abated with carbamazepine therapy. The pathophysiology may involve ephaptic transmission between demyelinated fibers in acute plaques within the corticospinal tract secondary to axonal irritation by lymphokines. (J Korean Neurol Assoc 19(2):167~169, 2001)