Paroxysmal Symptoms of Multiple Sclerosis

Short-Lasting Symptoms That Come and Go

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One of the characteristics of multiple sclerosis (MS) is the sometimes-frustrating way in which symptoms can suddenly appear out of nowhere, last for just a few minutes (or even mere seconds), and then disappear just as quickly. These types of symptoms are known as paroxysmal symptoms, which simply means that they come on suddenly and don't last long.

Female doctor explaining report to patient on digital tablet in clinic
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Paroxysmal symptoms can appear as a one-off event or in repeat cycles over the course of minutes, hours, or days. They may occur dozens or even a few hundred times a day and can be anything from annoying to downright painful. These intermittent events are commonly referred to as clusters, surges, or episodes, depending on the symptoms involved.

Some of the most common MS symptoms that can appear in a paroxysmal way include:

  • Diplopia: Also known as double vision, diplopia is caused by a weakness in the muscles controlling your eyes.
  • Paresthesias: These abnormal sensations are often described as a tingling, burning, itching, numbness, or "pins-and-needles" feeling.
  • Trigeminal neuralgia: This is an intense pain that occurs in one side of your face, often triggered by chewing or speaking.
  • Episodic ataxia: A sudden unsteadiness or lack of coordination, ataxia can cause you to stumble or drop things.
  • Dysarthria and dysphonia: These speech disorders cause slurring, slowed speech, changes in volume, and/or strange speech rhythms.
  • Lhermitte’s sign: This is a painful, electrical shock-like sensation that runs down your spine when your head is bent forward.
  • Pruritus: This sensation of itchy skin can be localized or generalized.
  • Dystonia: Often mistaken for a seizure, dystonia involves the disruption of voluntary muscle control or a sustained spasm in a group of muscles.
  • Dysphagia: With this, you lose control of the muscles involved in swallowing.
  • Akinesia: This occurs when your muscles freeze up, making it difficult or impossible to move.
  • Weakness
  • Pain

Paroxysmal symptoms tend to occur in the early stages of MS and typically go away within several weeks to months without recurring.


The paroxysmal symptoms of MS happen as a result of existing damage to your nerves. The hallmark of the disease is the way in which your body’s immune response progressively destroys the protective covering of nerves called the myelin sheath.

Once the damage has been done, these nerves are vulnerable to flare-ups simply because they are naked and exposed, much like electrical wiring without the insulated coating. Moreover, it often takes little to trigger symptoms. Even factors as innocuous as touch, temperature, humidity, stress, or fatigue may be enough to set off a neurological response.

When to See Your Healthcare Provider

Paroxysmal symptoms can be worrisome when you have MS but you're otherwise managing your disease just fine. You might be concerned that a sudden and short-lasting attack suggests that a relapse is imminent or that your disease is progressing.

In and of themselves, paroxysmal symptoms aren't considered an indication of relapse. They tend to come in short bursts and while they can be persistent in some cases, for most people, they subside within a few months without treatment.

Let your healthcare provider know about any symptoms of a paroxysmal nature that you experience, however minor. And if these symptoms are disrupting your quality of life, ask about treatment options to help quell them.

If your paroxysmal symptoms aren't going away, they're becoming more frequent, you're experiencing new ones, or they're accompanied by other continuous symptoms, consult your healthcare provider. It's possible that you're having a relapse, but only your practitioner can tell you that for sure.


Treating paroxysmal symptoms can be tricky because they're so brief and usually go away on their own with time. In fact, many people don't need any medical treatment for them.


If your paroxysmal symptoms are particularly bothersome or painful, research has shown that they often respond well to low-dose anticonvulsants like Tegretol (carbamazepine) or Depakote (valproic acid). Your healthcare provider may have other medications to offer you for relief as well, depending on what your symptoms are like.

Avoid Triggers

Since paroxysmal symptoms are often triggered by something in your environment, like being overheated, having too much stress, or being fatigued, one way you can help to minimize your symptoms is by avoiding any known triggers you have.

For instance, if fatigue makes your symptoms worse, you can work on making sure that you're practicing good sleep hygiene and that you're getting plenty of rest every night.

Unsure of your triggers? Try keeping a symptom diary to track what's going on in your life and your environment when your symptoms occur. You may spot some patterns that can help you nail down specific triggers or clue you into new ones you didn't even know you had.

A Word from Verywell

While there's no cure for MS, most symptoms of the disease can be managed with proper treatment. In the case of paroxysmal symptoms, the good news is that they tend to go away after several weeks or months and usually don't return. Talk to your healthcare provider about any concerns or questions you have about your symptoms. Our Healthcare Provider Discussion Guide below can help you start that conversation.

Multiple Sclerosis Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Woman
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Julie Stachowiak, PhD
Julie Stachowiak, PhD, is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award, Health Category.