Abstract
Two cases of multiple sclerosis with paroxysmal dysarthria and ataxia are described, and previously reported cases with similar symptoms and with other paroxysmal symptoms are discussed. Paroxysmal disturbances are differentiated from other transient disturbances in multiple sclerosis by explosive, repetitive occurrence and by localization to brain stem or cervical cord. The mechanisms are not known, but possibilities are (1) paroxysmal neuronal discharge in partially deafferented brainstem nuclei, (2) irritation of tracts with transversely spreading neuronal activation, or (3) rapidly reversible functional interruption of tracts. Paroxysmal symptoms may obscure the diagnosis. They appear to respond to treatment with carbamazepine.
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