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Multiple Sclerosis
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Article

Paroxysmal dystonia and pathological laughter as a first manifestation of multiple sclerosis

M. Aguirregomozcorta1*, L.I. Ramió-Torrentà1, J. Gich1, A. Quiles2, and D. Genís1

1 Neuroimmunology and Multiple Sclerosis Unit, Department of Neurology, Hospital Dr Josep Trueta, Girona, Spain
2 MRI Unit – IDI, Department of Radiology, Hospital Dr Josep Trueta, Girona, Spain

* To whom correspondence should be addressed.


  Abstract

Paroxysmal dystonia is an uncommon but well-established feature of multiple sclerosis (MS). Attacks can occur in established MS and may even occasionally be the initial symptom of this disorder. Pathological laughter is usually seen as a pseudobulbar palsy in some diffuse neurological diseases, but cases have been described, mostly in ischaemic attacks or tumours, where it is presented as bursts of laughter of variable duration. The pathogenesis of neither of the two phenomena has been fully established but both have been reported as being positive phenomena resulting from ectopic activation with ephaptic spread. We describe the first reported case of a paroxysmal hemidystonia together with bursts of pathological laughter as the first manifestation of MS. Multiple Sclerosis 2007; 00: 00–00. http://msj.sagepub.com

Key Words: demyelination; ephaptic; multiple sclerosis; paroxysmal dystonia; pathological laughter; tonic seizures; tonic spasms

First published on October 17, 2007, doi:10.1177/1352458507082053

Multiple Sclerosis 2008;14:262.

A more recent version of this article appeared on March 1, 2008
 This version was published on January 31, 2008
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