Paroxysmal pruritus as the fi rst relapsing symptom of neuromyelitis optica

ABSTRACT

Itching is a rare symptom in neurological disease. Paroxysmal symptom is uncommon in neuromyelitis optica (NMO) or multiple sclerosis. We describe a 45-year-old woman who presented with paroxysmal pruritus in association with relapse of NMO on two separate occasions. Cervical MRI showed a lesion at a level corresponding to the dermatomal site of the itching. Paroxysmal pruritus could be a predictive symptom of relapse in NMO unless there are other comorbid causes such as systemic diseases, allergy, drug reaction, or emotional stress responsible for the itching.