Association between paroxysmal tonic spasms and neuromyelitis optica

Arch Neurol. 2012 Jan;69(1):121-4. doi: 10.1001/archneurol.2011.832.


Objective: To determine the frequency of the association between tonic spasms and neuromyelitis optica (NMO) at our center.

Design: An institutional review board-approved retrospective study of clinical, serological, and radiographic characteristics of patients with NMO.

Setting: Multiple sclerosis center.

Patients: Patients with NMO treated at our center between 1990 and 2008.

Main outcome measure: Records were examined for documentation of tonic spasms.

Results: Of 110 patients with International Classification of Diseases code 341, 57 patients met diagnostic criteria for NMO. Of these, 8 patients (14%) had documented typical tonic spasms (median age at onset, 39.5 years; range, 13.8-54.2 years). Of those patients, 4 were African American, 3 were Hispanic, and 1 was white. Only 1 was male. The NMO-IgG antibody was found in 1 of 6 patients tested. Tonic spasms appeared after a mean of 24.6 months (range, 0-91 months). In 2 of 57 patients meeting NMO criteria, tonic spasms accompanied their initial episodes. Seven of 8 patients who had tonic spasms responded to treatment with carbamazepine within 1 week.

Conclusion: Tonic spasms are associated with NMO more commonly than with multiple sclerosis and may be a presenting sign in both diseases.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Dystonia / drug therapy
  • Dystonia / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuromyelitis Optica / diagnosis*
  • Neuromyelitis Optica / drug therapy
  • Neuromyelitis Optica / immunology
  • Neuromyelitis Optica / physiopathology*
  • Retrospective Studies