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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 3/2010

01-06-2010

Multiple Sclerosis-Related Central Pain Disorders

Authors: Turo J. Nurmikko, Sameer Gupta, Kate Maclver

Published in: Current Pain and Headache Reports | Issue 3/2010

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Abstract

Central neuropathic pain is common in multiple sclerosis (MS), and its prevalence increases with physical disability. Sufficient evidence links dysesthetic pain, trigeminal neuralgia, Lhermitte’s sign, and painful tonics spasms to plaque formation in the spinal cord and brain, whereas the association with headache and back pain remains unclear. Management varies according to the pain in question. For dysesthetic pain, drugs in use for neuropathic pain in general are recommended as first-line treatment, and emerging evidence suggests some benefit from cannabinoids and levetiracetam. Because of unique characteristics of MS-related trigeminal neuralgia, ganglion and root level neuroablative procedures are worth considering before microvascular decompression. Overall, the lack of controlled clinical trials, together with our limited understanding of the pathophysiological mechanisms involved, form a hindrance to a systematic and rational management of MS-related pain.
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Metadata
Title
Multiple Sclerosis-Related Central Pain Disorders
Authors
Turo J. Nurmikko
Sameer Gupta
Kate Maclver
Publication date
01-06-2010
Publisher
Current Science Inc.
Published in
Current Pain and Headache Reports / Issue 3/2010
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-010-0108-8

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