J Clin Neurol.  2020 Jan;16(1):124-130. 10.3988/jcn.2020.16.1.124.

Comparison of Neuropathic Pain in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis

Affiliations
  • 1Department of Neurology, National Cancer Center, Goyang, Korea. hojinkim@ncc.re.kr
  • 2Department of Neurology, Kosin University College of Medicine, Busan, Korea.
  • 3Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea.
  • 5Department of Neurology, Konkuk University School of Medicine, Seoul, Korea.
  • 6Department of Neurology, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE
To compare the characteristics of neuropathic pain in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS).
METHODS
From 2016 to 2018, 500 patients with NMOSD and MS from 6 referral hospitals in Korea underwent pain investigation. After the patients with current pain were matched for sex ratio and disease duration as confounding factors, PainDETECT questionnaires were assessed in 99 NMOSD and 58 MS patients to investigate neuropathic pain. The short form of the Brief Pain Inventory from 74 patients with neuropathic pain component was also analysed.
RESULTS
According to the PainDETECT questionnaire, mechanical allodynia (p=0.014) and thermal hyperalgesia (p=0.011) were more severe in NMOSD patients than in MS patients. Strong involvements (score >3) of the pain in domains of tingling/prickling sensation (p=0.024), mechanical allodynia (p=0.027), sudden pain attacks (p=0.018), and thermal hyperalgesia (p=0.002) were significantly more frequent in NMOSD compared to MS patients. Among the patients experiencing pain with a neuropathic component, total pain-related interference (p=0.045) scores were significantly higher in NMOSD patients than in MS patients. In daily life, pain interfered with normal work (p=0.045) and relationships with other people (p=0.039) more often in NMOSD patients than in MS patients. Although pain medication was prescribed more frequently in NMOSD patients, the percentage of patients experiencing medication-related pain relief was lower in those patients.
CONCLUSIONS
The severity of neuropathic pain and the pain-related interference in daily life were greater in NMOSD patients than in MS patients. Individualized analgesic management should be considered based on a comprehensive understanding of neuropathic pain in these patients.

Keyword

neuromyelitis optica spectrum disorder; multiple sclerosis; neuropathic pain

MeSH Terms

Humans
Hyperalgesia
Korea
Multiple Sclerosis*
Neuralgia*
Neuromyelitis Optica*
Referral and Consultation
Sensation
Sex Ratio
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