Abstract
Neuropathic pain and other pain syndromes occur in the vast majority of patients with multiple sclerosis at some time during their disease course. Pain can become chronic and paroxysmal. In this review, we will utilize clinical vignettes to describe various pain syndromes associated with multiple sclerosis and their pathophysiology. These syndromes vary from central neuropathic pain or Lhermitte's phenomenon associated with central nervous system lesions to trigeminal neuralgia and optic neuritis pain associated with nerve lesions. Muscular pain can also arise due to spasticity. In addition, we will discuss strategies utilized to help patients manage these symptoms.
Highlights
Multiple sclerosis (MS) is an inflammatory, demyelinating disorder of the central nervous system (CNS)
The type of pain syndrome that occurs in MS is typically associated with the part of the nervous system that is involved but has little to do with the type of MS or for how long the patient has had the disease [3]
Pain occurring in a region that has become anesthetic secondary to a sensory syndrome resulting in the perception of anesthetic numbness, but which later transforms into a region of pain generated by a non-painful stimulus
Summary
Multiple sclerosis (MS) is an inflammatory, demyelinating disorder of the central nervous system (CNS). Hope was a 32-year-old woman with a known history of relapsing remitting multiple sclerosis (RRMS) and no known other concomitant conditions She presented to clinic complaining of severe paroxysmal pain in the right VI and V2 region of the trigeminal nerve that occurred first after her husband gently caressed her right cheek. She exhibited the most robust, fast-acting, and improvement capability using IVMP when compared to oral steroid regimens of commensurate dosing While she markedly improved with respect to the magnitude of the pain’s intensity and frequency, Hope continued to experience multiple and debilitating shocks in the right face throughout the day. Hope remained unchanged, thereby suggesting that the new plaque, and its corresponding
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