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To determine the prevalence and nature of pain in multiple sclerosis,we evaluated by questionnaire,interview,and chart review 159 patients residing in Middlesex County and followed in the MS Clinic at University Hospital,London,Ontario,Canada.Eighty-eight patients(55%)had either an acute or chronic pain syndrome at some time during their disease.Fifteen patients(9%)with acute pain syndromes had episodes of paroxysmal tic-like pain diagnosed in seven as trigeminal neuralgia.Chronic pain syndromes, present for a mean duration of 4.9 years,occurred in 76 patients(48%)and included dysesthetic extremity pain(29%),back pain,(14%),painful leg spasms(13%),and abdominal pain(2%).MS patients with pain were similar to the pain-free group in mean age of onset(34.0 versus 31.9 years),average duration of disease(13.3%versus 12.1 years),spinal cord involvement(97%for each group),and mean rating on Kurtzke Disability Status Scale(4.2 versus 3.5).They differed in sex ratio with a higher female-to-male ratio in the pain group(3:1 versus 1.4:1).Chronic pain is a common feature of well- established MS and is usually associated with a myelopathy.Therapy must be individualized for each specific pain syndrome. |
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