Abstract
Pain is common and refractory in spinal cord injury (SCI). Currently, most studies evaluated pain in male‐predominant traumatic‐SCI. Also, concomitant secondary pain syndromes and its temporal evolution were seldom reported. We aimed to prospectively describe the main and secondary pain and its associated factors in inflammatory‐SCI evaluating neuromyelitis optica (NMO) patients.
In‐remission NMO patients underwent neurological, imaging and autoantibody evaluations. Questionnaires detailing main and secondary pains, functional state, mood, catastrophising, quality of life (QoL) and “non‐motor symptoms" were used at two time points.
Pain was present in 53(73.6%) of the 72 patients included. At‐level neuropathic pain was the most common main pain syndrome, affecting 32 subjects (60.4% of those with pain). Over 70% (n=38) of this cohort reported two pain syndromes. Those without pain were significantly younger (26.1±12.7 y.o. in those without pain and 40.1±12.5, 37.2±11.4 y.o. in those whose main pain was neuropathic and non‐neuropathic, respectively, p=0.001), and no differences in the inflammatory status were observed between groups. On follow‐up, one‐fifth (n=11) had a different main pain syndrome from the first visit. Pain impacted QoL as much as disability and motor strength.
Pain is a prevalent and disabling non‐motor symptom in NMO‐SCI. Most patients experience more than one pain syndrome which can change in time even in the absence of clinical relapse. Age of the inflammatory‐SCI was a major determinant of pain. Acknowledging temporal changes and multiplicity of pain syndromes in NMO‐SCI may give insights into more precise designs of clinical trials and general management of pain in SCI.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2XQc3E4
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