Pain in neuromyelitis optica: characterization and its impact on quality of life: a cross-sectional study in Venezuela
Author(s): ,
G.A Chique-Alfonzo
Affiliations:
Department of Neurology, Hospital Universitario de Caracas, Universidad Central de Venezuela;Department of Neurology, Centro Médico Docente La Trinidad
,
A Soto
Affiliations:
Department of Neurology, Centro Médico Docente La Trinidad;Neurology Unit, Hospital Dr. Domingo Luciani IVSS, Caracas, Bolivarian Republic of Venezuela
E Armas
Affiliations:
Department of Neurology, Hospital Universitario de Caracas, Universidad Central de Venezuela;Department of Neurology, Centro Médico Docente La Trinidad
ECTRIMS Online Library. Chique-Alfonzo G. 09/15/16; 146607; P767
Germán Arturo Chique-Alfonzo
Germán Arturo Chique-Alfonzo
Contributions
Abstract

Abstract: P767

Type: Poster

Abstract Category: Therapy - symptomatic - Quality of life

Background: Neuromyelitis Optica (NMO) comprises 11.8% of all Idiopathic Inflammatory Demyelinating Diseases (IIDDs) cases in South America (SA). Venezuela exhibits the highest frequency of NMO cases (43.3%) in SA. NMO has unique characteristics that could distinguish it from Multiple Sclerosis (MS). Recently, Pain in NMO, has been described as a disabling symptom that can affect health related quality of life (HRQOL).

Objective: To characterize and compare pain differences between NMO and MS in Venezuelan population, and determine its impact on HRQOL.

Methods:
In a cross-sectional study, 23 patients with NMO compared to 16 patients with MS were studied at the Department of Neurology, Hospital Universitario de Caracas, Venezuela. We used Brief Pain Inventory (BPI) to characterize pain, determine Pain Severity Index (PSI) and localize painful body areas. Douleur Neuropathique 4 (DN4) for determining neuropathic pain, Short Form 36 (SF-36) to measure HRQOL. Extended Disability Status Scale (EDSS) and Timed 25-Foot Walk (T25-FW) to assess disability and mobility. We determined the presence of Painful tonic spasms and the pain medication more commonly used, and ≥2 or more pain medication. We compared the NMO and MS patients´ profiles by Fisher exact probability test. We carried out all statistical analyses using SPSS version 22.0 (SPSS Inc.)

Results:
Pain in NMO seems to be more common, more severe and it shows particular characteristics compared to Pain in MS. EDSS NMO 6.11 vs. MS 4.97 (p=0.032). PSI in NMO 5.41±2.66 vs. MS 4.08 ±2.88 (p=0.220).Neuropathic Pain and Painful Tonic Spasms found (NMO) in 81% and 65% respectively. Severe painful areas in NMO were trunk and upper limbs bilateral (banding) while in MS were lower limbs unilaterally. NMO group had lower quality of life in physical and mental component of SF-36, compared to MS; and required ≥2 or more pain medication in 56.52% , especially NSAIDS and OPIOIDS. Comparing our data to international NMO studies, it seems that our results are consistent and show a more similar pattern to western North American studies than Asians do.

Conclusion: Pain in NMO showed different characteristics compared to MS; and it had a severe impact on quality of life in our patients. It requires a specialized diagnostic and therapeutic approach.

Keywords
: Neuromyelitis Optica, pain, neuropathic pain, brief pain inventory, SF36, quality of life

Disclosure: nothing to disclose

Abstract: P767

Type: Poster

Abstract Category: Therapy - symptomatic - Quality of life

Background: Neuromyelitis Optica (NMO) comprises 11.8% of all Idiopathic Inflammatory Demyelinating Diseases (IIDDs) cases in South America (SA). Venezuela exhibits the highest frequency of NMO cases (43.3%) in SA. NMO has unique characteristics that could distinguish it from Multiple Sclerosis (MS). Recently, Pain in NMO, has been described as a disabling symptom that can affect health related quality of life (HRQOL).

Objective: To characterize and compare pain differences between NMO and MS in Venezuelan population, and determine its impact on HRQOL.

Methods:
In a cross-sectional study, 23 patients with NMO compared to 16 patients with MS were studied at the Department of Neurology, Hospital Universitario de Caracas, Venezuela. We used Brief Pain Inventory (BPI) to characterize pain, determine Pain Severity Index (PSI) and localize painful body areas. Douleur Neuropathique 4 (DN4) for determining neuropathic pain, Short Form 36 (SF-36) to measure HRQOL. Extended Disability Status Scale (EDSS) and Timed 25-Foot Walk (T25-FW) to assess disability and mobility. We determined the presence of Painful tonic spasms and the pain medication more commonly used, and ≥2 or more pain medication. We compared the NMO and MS patients´ profiles by Fisher exact probability test. We carried out all statistical analyses using SPSS version 22.0 (SPSS Inc.)

Results:
Pain in NMO seems to be more common, more severe and it shows particular characteristics compared to Pain in MS. EDSS NMO 6.11 vs. MS 4.97 (p=0.032). PSI in NMO 5.41±2.66 vs. MS 4.08 ±2.88 (p=0.220).Neuropathic Pain and Painful Tonic Spasms found (NMO) in 81% and 65% respectively. Severe painful areas in NMO were trunk and upper limbs bilateral (banding) while in MS were lower limbs unilaterally. NMO group had lower quality of life in physical and mental component of SF-36, compared to MS; and required ≥2 or more pain medication in 56.52% , especially NSAIDS and OPIOIDS. Comparing our data to international NMO studies, it seems that our results are consistent and show a more similar pattern to western North American studies than Asians do.

Conclusion: Pain in NMO showed different characteristics compared to MS; and it had a severe impact on quality of life in our patients. It requires a specialized diagnostic and therapeutic approach.

Keywords
: Neuromyelitis Optica, pain, neuropathic pain, brief pain inventory, SF36, quality of life

Disclosure: nothing to disclose

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