Paroxysmal Dystonia Most Common Movement Disorder in Demyelinating Diseases

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Investigators sought to determine common movement disorders associated with multiple sclerosis and neuromyelitis optica spectrum disorders.

The most common movement disorder in patients with demyelinating diseases is paroxysmal dystonia, according to results published in Parkinsonism and Related Disorders.

In addition, the results indicated a strong association between paroxysmal dystonia and neuromyelitis optica spectrum disorder (NMOSD).

The study included participants with multiple sclerosis (MS) or NMSOD (n=253, 208 with MS, 45 with NMOSD). A movement disorder specialist evaluated all participants, and each participant underwent a personal interview and neurological examination. The researchers used the Fahn-Tolosa-Marin tremor rating scale to evaluate tremors, and they assessed health-related quality of life with the EuroQol questionnaire.

Of the 253 participants, 26% (49 with MS, 17 with NMOSD) were determined to have movement disorders. The most common movement disorders were paroxysmal dystonia (n=32) and tremor (n=27). The diagnosis of NMOSD was strongly associated with paroxysmal dystonia (odds ratio [OR] 22.07; 95% CI, 2.56-189.78; P =.005).

Participants with MS and a low Expanded Disability Status Scale score (below 4.0) had fewer movement disorders than patients with NMOSD.

“The presence of paroxysmal dystonia in an appropriated clinical context should be a clue for the diagnosis of NMOSD,” the researchers wrote.

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Conflicts of Interest

Carolina Candeias da Silva has travel expenses to scientific meetings sponsored by Roche. Denis Bernardi Bichuetti has received speaking/consulting honoraria from Bayer Health Care, Biogen, Idec, Merck Serono, Genzyme, Sanofi, TEVA and Roche and had travel expenses to sci- entific meetings sponsored by Bayer Health Care, Merck Serono, TEVA, and Roche. Sonia Maria Cesar de Azevedo Silva has travel expenses to sci- entific meetings sponsored by Roche. Henrique Balalai Ferraz declares that he has no conflict of interest. Enedina Maria Lobato de Oliveira is a member of the advisory board in Brazil: Merck Serono, Genzyme, has received speaker fee from Teva, Biogen, Genzyme, and travel expenses to scientific meetings sponsored by Merck Serono.

Vanderci Borges has travel expenses to scientific meetings sponsored by Roche.


Candeias da Silva C, Bichuetti DB, Cesar de Azevedo Silva SM, et al. Movement disorders in multiple sclerosis and neuromyelitis optica: a clinical marker of neurological disability [published online March 3, 2018] Parkinsonism Relat Disord. doi:10.1016/j.parkreldis.2018.03.001