Multiple sclerosis and pain.
Despite the common belief that multiple sclerosis (MS) is a painless disease, several studies contradict this. There are a significant number of MS patients who actually suffer from painful conditions such as central and peripheral neuropathy, migraines, trigeminal neuralgia, painful  tonic spasms, complex regional pain syndrome, glossopharyngeal neuralgia, and transverse myelitis. In addition, MS relapses are usually painful with many patients complaining of paroxysmal dystonia and neuropathic pain during these episodes. Additionally, treatments for MS such as use of beta-interferons  may be associated with headache and pain at the injection site. The pathophysiology of pain in MS is poorly understood, but may be related to the development of demyelinating lesions involving certain neuroanatomic pathways such as the spinothalamic tract. Management of pain in MS patients  is a therapeutic challenge for clinicians. Currently, various pharmacological agents such as antiepielptics, non-steroidal anti-inflammatory agents, and even corticosteroids are used to suppress various painful conditions associated with MS. Non-pharmacological procedures such as massage therapy  have also been used in the treatment of MS patients. The authors present a review of recent findings in pathophysiology and management of pain in MS patients.
Department of Neurology, LSU Health Sciences Center, Shreveport, LA, USA.
Saeed Talebzadeh
ST
Nick
Charles
C
Roberts
Seth
S
Billiodeaux
Debra Elliott
DE
Davis
Behrouz
B
Zamanifekri
Mohammad Ali
MA
Sahraian
Nadejda
N
Alekseeva
Sai
S
Munjampalli
Joann
J
Roberts
Alireza
A
Minagar
D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications* / Q000188:drug therapy; D010146:Pain / Q000145:classification / Q000209:etiology*