Oxcarbazepine (OXC) is an anitepileptic medication recently approved as monotherapy for partial onset seizure and demonstrated to be useful in the treatment of several neuropathic pain. We performed an open-label pilot study of OXC (dosage 600-1200 mg/day) in 12 multiple sclerosis (MS) patients suffering painful paroxysmal symptoms. Eight subjects were female and 4 male, with a mean age of 43.6 years, mean disease duration of 7.3 years and mean score at the EDSS of 3.2. Ten patients had a relapsing-remitting disease course, 1 had secondary progressive and 1 had primary progressive course. Painful paroxysmal symptoms (PPS) were defined as transient painful symptoms in any area of the body, with abrupt onset, brief duration, from a few seconds to a few minutes, with repetitive and stereotyped features. The subjective level of the PPS was scored using a three-point scale (0-3). The mean dosage of OXC was 1033 mg daily. Nine patients experienced a complete and sustained recovery within 1 month from treatment initiation (T0 vs. T1, p>0.05). Two patients dropped out of the study due to adverse effects: 1 case of nausea and dizziness, 1 case of C. hyponatraemia. The medication was well tolerated in the majority of the subjects. The study results provide a new possibility for treating painful symptoms in MS, but efficacy on PPS must be confirmed in a larger study.