There is a high prevalence of pain among patients with neuromyelitis optica spectrum disorder (NMOSD), and identifying this pain may be useful in localizing the disease, says a new retrospective study published in the journal Multiple Sclerosis and Related Disorders. The presence of aquaporin-4 antibody (AQP4-ab) in serum is an independent risk factor for NMOSD pain.

Even though pain is a common symptom of NMOSD, studies on pain in NMOSD are scarce.

Here, a team of researchers from the First Hospital of Shanxi Medical University in Taiyuan, China, analyzed the medical records of 145 patients with NMOSD. The investigators specifically looked at clinical characteristics of pain. The patients were admitted to the hospital between July 2016 and June 2019.

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The researchers found that the most common type of NMOSD pain was neuropathic pain, affecting 79.5% of patients. This was followed by optic neuritis-related eye pain, painful tonic spasms, and headaches.

There was no correlation between pain and sex, age of the patient, age of onset of the symptoms, disease course, recurrence rate, level of disability, spinal cord segment involvement, or the presence of intracranial lesions, autoimmune diseases, autoimmune antibodies, or initial symptoms. The only factors affecting pain were AQP4-ab positivity and pruritus.

The researchers concluded that there is a high prevalence of pain in patients with NMOSD, and pain can be used to localize the disease.

They also noted that treatment with hormones and biological immune agents may be effective in some cases, but it is essential to be aware of possible interactions when choosing a treatment.

The investigators pointed out that instead of using unilateral pain management, clinicians should follow a comprehensive treatment plan.

NMOSD is a rare autoimmune disease affecting the central nervous system characterized by recurrent optic neuritis. Patients with the condition often describe their pain as eye pain, headaches, and cramps.


Xue H, Yang W, Zhao Y, et al. Pain in neuromyelitis optic spectrum disorder. Mult Scler Relat Disord. Published online September 23, 2022. doi:10.1016/j.msard.2022.104192