The frequency of paroxysmal tonic spasm in multiple sclerosis

Abstract

BACKGROUND: Multiple sclerosis (MS) is one of the most important neurological diseases with autoimmune pathogenesis characterized by demyelination of the central nervous system (CNS) with various spectrum of neurological manifestations. The most common form which is the relapsing-remitting type can be presented with visual, sensory, motor, cerebellar, and sphincteric disturbances lasting for days or even months.

OBJECTIVES: To determine the frequency of paroxysmal tonic spasms in a group of Iraqi multiple sclerosis patients and to determine possible disease characteristics associated with increased risk of paroxysmal tonic spasms.

METHOD: A cross-sectional study included 110 patients that have been diagnosed with MS based on 2017 McDonald criteria and visited regularly the MS clinic at Ibn-Sina specialized hospital (period, 01.09.2022-01.02.2023). These patients were diagnosed with TS clinically and evaluated radiologically and by electroencephalography to exclude conditions other than Tonic spasm.

RESULTS: A total of 16 MS patients (14.5%) had paroxysmal TS. Older age patients and those with long disease courses and high EDSS scores were found to be correlated with the occurrence of tonic spasms. Moreover, pyramidal and sensory system impairments were significant risk factors for paroxysmal Tonic spasms.

CONCLUSIONS: Tonic spasm is significantly associated with Multiple sclerosis with a frequency of 14.5%. Motor system impairment and higher EDSS score were the most remarkable predictor risk factors to have a tonic spasm.