Editing Paroxysmal attack (section)

{{short description|Sudden intensification or recurrence of medical symptoms}}
{{redirect|Paroxysms|the waltz by Johann Strauss|Paroxysmen}}
{{distinguish|proximal}}
{{Infobox medical condition (new)
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| synonyms       = Paroxysms
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'''Paroxysmal attacks''' or '''paroxysms''' are a sudden recurrence or intensification of [[symptom]]s, such as a [[spasm]] or [[seizure]].<ref>Saunders Elsevier, "Dorland's Illustrated Medical Dictionary 31e", Philadelphia (2007), p1405, {{ISBN|978-1-4160-2364-7}}</ref> These short, frequent symptoms can be observed in various clinical conditions. They are usually associated with [[multiple sclerosis]] or [[pertussis]], but they may also be observed in other [[disease|disorder]]s such as [[encephalitis]], head [[Physical trauma|trauma]], [[stroke]], [[autism spectrum|autism]], [[asthma]], [[trigeminal neuralgia]], [[breath-holding spells]], [[epilepsy]], [[malaria]], [[tabes dorsalis]], [[Behçet's disease]], and [[paroxysmal nocturnal hemoglobinuria]] (PNH). It has also been noted as a symptom of [[gratification disorder]] in children.{{citation needed|date=December 2020}}

The word ''[[wikt:paroxysm|paroxysm]]'' means 'sudden attack, outburst'<ref>[https://archive.today/20120718060816/http://oxforddictionaries.com/definition/paroxysm?q=paroxysm paroxysm], on Oxford Dictionaries</ref> and comes {{ety|el|''παροξυσμός'' (paroxusmós)|irritation, exasperation}}.<ref>[https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3Dparocusmo%2Fs παροξυσμός], Henry George Liddell, Robert Scott, ''A Greek-English Lexicon'', on Perseus</ref>

Paroxysmal attacks in various disorders have been reported extensively, and [[ephaptic coupling]] of [[myelin|demyelinated]] [[nerve]]s has been presumed as one of the underlying mechanisms of this phenomenon. This is supported by the presence of these attacks in multiple sclerosis and tabes dorsalis, which both involve demyelination of spinal cord neurons.  Exercise, tactile stimuli, hot water, anxiety, and neck flexion may provoke paroxysmal attacks. Most reported paroxysmal attacks are painful [[Tonic (physiology)|tonic]] [[spasm]]s, [[dysarthria]] and [[ataxia]], [[numbness]], and [[hemiparesis]]. They are typically different from other [[wikt:transience|transient]] symptoms by their brevity (lasting no more than 2 minutes), frequency (from 1–2 times/day up to a few hundred times/day), stereotyped fashion, and excellent response to drugs (usually [[carbamazepine]]). Withdrawal of symptoms without any residual [[neurological finding]] is another key feature in their recognition.{{citation needed|date=December 2020}}