Pharyngeal Painful Tonic Spasms: Paroxysmal Painful Swallowing
Authors: Domenico A. Restivo, Claudio Solaro, Davide Maimone, Antonino Pavone, Rosario Marchese-Ragona
Journal: Annals of Internal Medicine (2011)

Letters1 November 2011Pharyngeal Painful Tonic Spasms: Paroxysmal Painful SwallowingDomenico A. Restivo, MD, PhD, Claudio Solaro, MD, Davide Maimone, MD, PhD, Antonino Pavone, MD, and Rosario Marchese-Ragona, MDDomenico A. Restivo, MD, PhDFrom "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; AUSL 3 Genovese, Genova, Italy; "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; and University of Padova, Padova, Italy., Claudio Solaro, MDFrom "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; AUSL 3 Genovese, Genova, Italy; "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; and University of Padova, Padova, Italy., Davide Maimone, MD, PhDFrom "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; AUSL 3 Genovese, Genova, Italy; "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; and University of Padova, Padova, Italy., Antonino Pavone, MDFrom "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; AUSL 3 Genovese, Genova, Italy; "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; and University of Padova, Padova, Italy., and Rosario Marchese-Ragona, MDFrom "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; AUSL 3 Genovese, Genova, Italy; "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; and University of Padova, Padova, Italy.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-155-9-201111010-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Painful tonic spasms occur in about 11% of patients with multiple sclerosis (1). The spasms are typically transient, are limited to upper and lower limbs, and occur several times per day. They are caused by abnormal (ephaptic) spreading of electrical discharges across the membranes of demyelinated axons independent of synapses (2) and are often treated successfully with antiepileptic drugs (2). Electromyography (EMG) shows abnormal involuntary hyperactivity in the involved muscles (3).Objective: To describe painful tonic spasms of the pharyngeal muscles induced by voluntary swallowing, which we believe is a previously unrecognized condition that is potentially treatable, in 2 ...References1. Solaro C, Brichetto G, Amato MP, Cocco E, Colombo B, D'Aleo G, et al; PaIMS Study Group. The prevalence of pain in multiple sclerosis: a multicenter cross-sectional study. Neurology. 2004;63:919-21. [PMID: 15365151] CrossrefMedlineGoogle Scholar2. Solaro C, Lunardi GL, Capello E, Inglese M, Messmer Uccelli M, Uccelli A, et al. An open-label trial of gabapentin treatment of paroxysmal symptoms in multiple sclerosis patients. Neurology. 1998;51:609-11. [PMID: 9710049] CrossrefMedlineGoogle Scholar3. Restivo DA, Tinazzi M, Patti F, Palmeri A, Maimone D. Botulinum toxin treatment of painful tonic spasms in multiple sclerosis. Neurology. 2003;61:719-20. [PMID: 12963779] CrossrefMedlineGoogle Scholar4. Restivo DA, Marchese-Ragona R, Patti F, Solaro C, Maimone D, Zappalá G, et al. Botulinum toxin improves dysphagia associated with multiple sclerosis. Eur J Neurol. 2011;18:486-90. [PMID: 20731706] CrossrefMedlineGoogle Scholar5. Baehr PH, McDonald GB. Esophageal disorders caused by infection, systemic illness, medications, radiation, and trauma. 6th ed.. In: Feldman M, Scharschmidt BF, Sleisenger MH, eds. Gastrointestinal and Liver Disease. 6th ed. Philadelphia: WB Saunders; 1998:519-39. Google Scholar Author, Article, and Disclosure InformationAuthors: Domenico A. Restivo, MD, PhD; Claudio Solaro, MD; Davide Maimone, MD, PhD; Antonino Pavone, MD; Rosario Marchese-Ragona, MDAffiliations: From "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; AUSL 3 Genovese, Genova, Italy; "Nuovo Garibaldi" Hospital, 95100 Catania, Italy; and University of Padova, Padova, Italy.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMovement Disorders in Multiple Sclerosis: An UpdateParoxysmal Symptoms in Multiple Sclerosis—A Review of the LiteratureEpisodic hemilaryngopharyngeal spasm (HELPS) syndrome: case report of a surgically treatable novel neuropathy 1 November 2011Volume 155, Issue 9Page: 649-650KeywordsAntiepileptic drugDisabilitiesDysphagiaElectromyographyMagnetic resonance imagingMultiple sclerosisMusclesPharynxSwallowingThyroid ePublished: 1 November 2011 Issue Published: 1 November 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...