S36. Neuropathic pain is common in sensory neuronopathy and may play a role in its diagnostic delay

Abstract

Introduction Sensory neuronopathies (SN) are a distinct group of peripheral nerve disorders that emerge from the dorsal root ganglia damage. The resultant phenotype is characterized by multifocal non-length dependent sensory deficits. This pattern of sensory impairment produces a sensory symptoms spectrum with different combinations of sensory ataxia and pain. Neuropathic pain (NP) is often present in the context of SN, however its description and its impact on SN diagnosis delay have not been previously addressed. Objective To describe neuropathic pain in SN patients and to evaluate its impact on the diagnosis delay of these patients. Methods We evaluated 40 consecutive patients with SN who were regularly followed in a tertiary neuromuscular clinic. For each patient, we obtained data regarding the presence of pain, the Leeds assessment of neuropathic symptoms and signs (LANSS) score was obtained and all patients were actively interrogated regarding the onset of the SN symptoms, previous diagnoses for which they were eventually treated, the number and the specialty of previous physicians consulted. Non-parametric tests were used and p values Results The mean age of SN patients was 50.9 ± 11.3 years and there were 30 women. For 33 SN patients pain was part of the clinical picture and for22 of those, the pain was described as neuropathic accordingly to LANSS (LANSS scores ⩾ 12). None of these patients was first evaluated in our center by the time of the settlement of SN symptoms. Every patient was evaluated by a mean of 4.32 ± 2.21 specialists and received a mean of 3.1 ± 1.4 wrong different diagnoses. The mean time between the SN symptoms onset and the proper SN diagnosis was 5.47 ± 5.3 years. Considering those patients with and without NP the mean time to the SN diagnose was 7.13 ± 6.3 and 3.44 ± 2.7 years (p = 0.026) respectively. Conclusion These results suggest that pain, specially the NP, is a common feature in SN and may impose a significant delay for its correct diagnosis.