Paroxysmal painful tonic spasms in neuromyelitis optica spectrum disorder

Article Article scientifique Rapport de cas Paroxysmal painful tonic spasms in neuromyelitis optica spectrum disorder eng 2023-01-13 2023-03 author Lucas Shoena Faculty of Medicine, University of Geneva, Geneva, Switzerland. 849756 author Lalive d'Epinay Patrice Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Department of Clinical Neuroscience, Geneva University Hospitals, Geneva, Switzerland. 636926 Département des neurosciences cliniques (OTONO) author Lascano Agustina Maria 0000-0001-7572-8811 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Department of Clinical Neuroscience, Geneva University Hospitals, Geneva, Switzerland. 636053 Département des neurosciences cliniques (OTONO) 100443 10.1016/j.ensci.2023.100443 36698772 2405-6502 PMC9868373 https://www.sciencedirect.com/science/article/pii/S2405650223000011 Background: Recently, an association between painful tonic spasms (PTS) and Neuromyelitis Optica Spectrum Disorder (NMOSD) was established. Objective: To describe the clinical characteristics of PTS in NMOSD based on a video recording and to provide a literature review on the topic. Methods: We report a case of a 38 years-old woman with a diagnosis of NMOSD and positive aquaporin-4 IgG antibody status who developed PTS five weeks after an episode of longitudinal extensive transverse myelitis (LETM). Results: Repetitive, brief, and painful episodes of muscle contraction were observed on the patient's left hand, spreading to the left arm, and then extending to the four limbs. While pregabalin and topiramate had no influence on these episodes, the patient responded to carbamazepine (CBZ), without symptom recurrence after one year. Conclusions: PTS in association with LETM can be considered typical for NMOSD. Although the exact mechanism is unknown, ephaptic transmission after spinal cord damage and excitatory soluble factors released during acute inflammation responses are sought to be involved. Symptomatic treatment with CBZ achieved remission of spams in our case. AQP4 Area postrema syndrome Case report Central nervous system Longitudinal extensive transverse myelitis Magnetic resonance imaging Multiple sclerosis NMOSD Spinal movement disorder Tonic seizures Autoimmune Dewey 616.8 61 Département des neurosciences cliniques 226 false 505 Scléroses en plaques, neuroimmunologie, encéphalite autoimmune expérimentale 843 eNeurologicalSci 30 0f7d1a35-4543-4fd2-898d-f1c9e81f97a2 Article (Published version) Public nmosd.pdf 1765149 application/pdf CC BY-NC-ND-4.0 c7dfd9036e24f0c1a8c6ab9167b8c16980135bc2de6907532ee914319d3383e0 050e14ee-b8ff-4281-8e2d-4bf01848565b Supplemental data Public 1-s2.0-S2405650223000011-mmc1.docx 32681 application/vnd.openxmlformats-officedocument.wordprocessingml.document bfdf991adb4a1d2ed4ea6f2562ea03e3a634809d138b5cf57cfec6581a0c7786 35e46814-6eb7-4fd0-ac06-645f8b8211ea Supplemental data Public 1-s2.0-S2405650223000011-mmc2.mp4 8316857 video/mp4 73e1e99875238bc0ff7b830df4489e6564eaa86e40ac3f31b92ad889a8566bf6 openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques

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Paroxysmal painful tonic spasms in neuromyelitis optica spectrum disorder	eNeurologicalSci			2023	65	135

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Lucas, Shoena