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Review
. 2024 Jun 3;16(6):e61587.
doi: 10.7759/cureus.61587. eCollection 2024 Jun.

Neuropathic Pain Secondary to Multiple Sclerosis: A Narrative Review

Billy McBenedict  1 , Kang Suen Goh  2 , Ryan Chun Chien Yau  2 , Sara Elamin  3 , Walaa H Yusuf  4 , Gabriel Verly  5 , Anusha Thomas  6 , Berley Alphonse  7 , Kaoutar Ouabicha  8 , Gabriella Valentim  9 , Wilhelmina N Hauwanga  10 , Bruno Lima Pessôa  1
Affiliations
Review

Neuropathic Pain Secondary to Multiple Sclerosis: A Narrative Review

Billy McBenedict et al. Cureus. .

Abstract

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS). Neuropathic pain in MS is a debilitating symptom that significantly impairs the quality of life for a substantial proportion of MS patients. Neuropathic pain in MS stems primarily from demyelination, axonal loss, CNS inflammation, and direct damage to the myelin sheath, leading to pain manifestations such as ongoing extremity pain, Lhermitte's phenomenon, and trigeminal neuralgia (TN). The pathophysiological mechanisms behind MS-related neuropathic pain are explored in this review, highlighting central sensitization, neural dysfunction, spinal thalamic tract dysfunction, and inflammatory processes that exacerbate neuronal damage. Neuropathic pain in MS necessitates comprehensive assessment tools and neurophysiological tests to differentiate neuropathic pain from other MS symptoms accurately. Treatment strategies for MS-related neuropathic pain encompass pharmacological interventions, including anticonvulsants and antidepressants, and emerging therapies targeting specific inflammatory processes. The review advocates for a holistic approach to management, incorporating innovative treatments and multidisciplinary strategies to address both the physical symptoms and psychosocial aspects of this disorder. This comprehensive overview underscores the importance of ongoing research into targeted therapies to improve patient outcomes and enhance the quality of life for those affected by MS.

Keywords: central sensitization; demyelination; multidisciplinary approaches; multiple sclerosis; neuropathic pain.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Mind map exploring the etiology and management strategies.
The mind map was constructed from the articles included in the review and generated using the Miro Mind Mapping tool [27-49].
See this image and copyright information in PMC

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