Multiple sclerosis is a common inflammatory demyelinating disease of the central nervous system. Although many patients present permanent symptoms, a number of them suffer of deficits of paroxysmal character. One unusual manifestation of paroxysmal nature is episodes of dysarthria and ataxia known as PDA (paroxysmal dysarthria and ataxia). The mechanism behind this phenomenon, although not well understood, is hypothesised to relate with ephaptic activation of the neuroaxons within the demyelination plaques. Just a few patients worldwide have been reported at present. These symptoms can be effectively treated with anti-seizure medicines. We present the case of a female 48-year-old patient who shortly after an MS diagnosis developed paroxysmal dysarthria and ataxia related to a midbrain lesion and was eventually treated with carbamazepine.
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