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Paroxysmal Limb Hemiataxia With Crossed Facial Paresthesias in Multiple Sclerosis

David M. Skillrud, MD; Norman P. Goldstein, MD
JAMA. 1983;250(20):2843-2844. doi:10.1001/jama.1983.03340200077035.
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THE MYRIAD potential symptoms of multiple sclerosis (MS) include paroxysmal phenomena. Episodic attacks of tonic spasms, paresthesias, pain, pruritus, akinesia, diplopia, dysarthria with ataxia, and hemiataxia with paresthesias have all been reported.1 Most of these paroxysmal events have been responsive to therapy with carbamazepine.2 This report describes an account of an uncommon type of attack—paroxysmal hemiataxia with crossed paresthesias—and its responsiveness to therapy with carbamazepine and phenytoin.

Report of a Case  A 27-year-old male physician had intermittent incoordination of the left upper and lower limbs accompanied by right facial paresthesias. Three years previously, he had experienced pruritic and tingling paresthesias of the left upper limb, extending into the first three digits. Neurological findings at that time were normal, as were roentgenograms of the cervical spine. The pruritic component resolved within days and the tingling paresthesias diminished over the next several months, but a mild "numbness or deadness" persisted


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