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Chapter 13 - Central pain symptoms in multiple sclerosis

from Section 4 - The Specific Condition: Central Neuropathic Pain

Published online by Cambridge University Press:  05 December 2013

By
Scott Jarvis  and
Bradley J. Kerr
Edited by
Cory Toth  and
Dwight E. Moulin
Cory Toth
Affiliation:
Department of Neurology, University of Calgary
Dwight E. Moulin
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario
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Summary

Multiple sclerosis (MS) can lead to numerous types of pain through the processes of inflammation and degeneration. The common types of pain seen in MS include dysesthetic/extremity pain, trigeminal neuralgia (TN), spasticity, L'hermitte's phenomenon, painful tonic spasms (PTS), musculoskeletal, headache, optic neuritis, and treatment related pain. This chapter focuses on the first five, with a particular focus on dysesthetic pain. The acute onset of dysesthetic pain in the setting of a relapse in a relapsing-remitting MS (RRMS) patient is clearly due to an inflammatory lesion. The inciting pathology of TN in MS is a lesion which affects the primary afferents of the trigeminal nerve after they enter the pons, distal to the trigeminal nuclear complex, in the root entry zone (REZ). Considering that people with MS are already predisposed to poor sleep, depression, and a poor quality of life, the presence of pain is particularly debilitating.

Keywords

sensory systemsneurotrophin receptorsion channelsmetabotropic G protein-coupled receptorsneuropathic painnociceptor hyperexcitabilityperipheral sensitizationcytokinescentral inhibitory pathwayscentral sensitization
Type
Chapter
Information
Neuropathic Pain
Causes, Management and Understanding
 , pp. 156 - 169
Publisher: Cambridge University Press
Print publication year: 2013

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