# Painful Paroxysmal Dystonia as a Revealing Symptom of Multiple Sclerosis: A Case Report and Literature Review

## TL;DR

A rare case of multiple sclerosis was identified through painful dystonic movements, highlighting the importance of recognizing unusual symptoms for early diagnosis.

## Contribution

This case report emphasizes painful paroxysmal dystonia as a rare but significant initial symptom of multiple sclerosis.

## Key findings

- A 51-year-old woman presented with painful dystonic movements linked to multiple sclerosis.
- MRI confirmed demyelinating lesions consistent with MS, and corticosteroid therapy improved symptoms.
- Early recognition of atypical motor symptoms is crucial for timely MS diagnosis and treatment.

## Abstract

Multiple sclerosis (MS) can present with a wide range of motor symptoms, including movement disorders that are often underrecognized. Among these, painful paroxysmal dystonias, though rare, are particularly important to recognize when they occur as an initial manifestation. We report the case of a 51-year-old woman with no significant past medical history who presented with recurrent, brief, painful dystonic movements affecting the right upper limb and hemiface. Magnetic resonance imaging (MRI) revealed demyelinating lesions consistent with MS, and clinical improvement was achieved with corticosteroid therapy. Early recognition of such presentations is essential for accurate diagnosis and timely management.