Paroxysmal pruritus as the fi rst relapsing symptom of neuromyelitis optica

Itching is a rare symptom in neurological disease. Paroxysmal symptom is uncommon in neuromyelitis optica (NMO) or multiple sclerosis. We describe a 45-year-old woman who presented with paroxysmal pruritus in association with relapse of NMO on two separate occasions. Cervical MRI showed a lesion at a level corresponding to the dermatomal site of the itching. Paroxysmal pruritus could be a predictive symptom of relapse in NMO unless there are other comorbid causes such as systemic diseases, allergy, drug reaction, or emotional stress responsible for the itching. Neurology Asia 2010; 15(2) : 185 – 187 Address correspondence to: Sang-Soo Lee MD, Department of Neurology, Chungbuk National University School of Medicine, 410 Sungbong-ro, Cheongju-si, Chungbuk, 361-711, Korea. Phone: 82432696336, Fax: 82-43-275-7591, Email: [email protected] INTRODUCTION Paroxysmal symptoms in neuromyelitis optica (NMO) or multiple sclerosis (MS) are defi ned as those that last for seconds or minutes. This is in contrast with exacerbations where the symptoms exist for at least 1 or 2 days. Paroxysmal itching in MS patients has been rarely reported, but it was not described in NMO. Here, we describe a NMO patient with paroxysmal pruritus that was a predictive symptom of relapse. The dermatomal location of itching was well-correlated with the spinal cord lesion on MRI.