Transcutaneous electrical nerve stimulation (tens) in brain stem paroxysms: case report

Abstract

INTRODUCTION: Brainstem paroxysmia has been described in patients with multiple sclerosis, characterized by rapid episodes of nystagmus and vertigo evoked by cephalic movements. Neuromodulation has shown therapeutic success for several dysfunctions of multiple sclerosis, but it has not yet been used in paroxysmia. OBJECTIVE: To assess the additive effect of neuromodulation by transcutaneous electrical neural stimulation (TENS) on the periocular musculature in a patient with multiple sclerosis and brain stem paroxysmia that is not responsive to classical rehabilitation associated with medication. MATERIAL AND METHODS: Nystagmus evaluation with videonystagmograph, facial skin sensitivity analysis with esthesiometer, video recording of blepharoclonus and pain sensation subjectively quantification (by personal description of patient); execution of 10 eyes consecutive exercises sessions associated with TENS in the right lower oblique and lateral rectum muscles. RESULT: Improvement in pain, blepharoclonus and right eye nystagmus. CONCLUSION: Neuromodulation with TENS seems to be a valid complementary therapy for patients with brainstem paroxysmia unresponsive to other clinical treatments, but more studies are needed to confirm this finding.