Paroxysm: Paroxysmal Attacks, Definition and Development

Index

The paroxysm refers to the violent attack of a disease.

The paroxysm, also known as paroxysmal attacks, is a sudden recurrence or intensification of the symptoms of a certain condition or disease, such as a spasm or attack. The paroxysm is the most critical stage of a disease.

It may be due to the sudden onset of symptoms or to the acute exacerbation (the abrupt worsening) of pre-existing symptoms.

The word paroxysm means “sudden attack, outburst” and comes from the Greek παροξυσμός (paroxusmos), “irritation, exasperation”.

Paroxysmal symptoms are short and frequent and can be observed in various clinical situations.

They are usually associated with multiple sclerosis or whooping cough, but can also be seen in other disorders such as encephalitis, head trauma, stroke, asthma, trigeminal neuralgia, episodes of breath retention, epilepsy, malaria, tabes dorsal and Behçet’s disease, paroxysmal hemoglobinuria night (HPN).

It has also been observed as a symptom of the gratification disorder in children.

Paroxysmal attacks have been reported extensively in various disorders and it is presumed that the epheptic coupling of demyelinated nerves is one of the underlying mechanisms of this phenomenon.

This is supported by the presence of these attacks in multiple sclerosis and dorsal tabes, which involve the demyelination of the neurons of the spinal cord.

Development of the paroxysm

Exercise, tactile stimuli, hot water, anxiety and neck flexion can cause paroxysmal attacks. Most reported paroxysmal attacks are painful tonic spasms, dysarthria and ataxia, numbness and hemiparesis.

They are usually different from other transient symptoms because of their brevity (which lasts no longer than 2 minutes), frequency (1 to 2 times per day up to a few hundred times per day), stereotypical fashion and excellent response to drugs (usually carbamazepine). The withdrawal of symptoms without any residual neurological findings is another key feature in their recognition.