Abstract Details

Title The "MS Hug": Definition, Characteristics, Course, and Misattribution Risk

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-111

Objective

To describe the characteristics and outcome of patient-reported dysesthetic sensory symptoms known as the “MS hug” in people with multiple sclerosis (MS).

Background The term “MS hug” is widely recognized by people with MS and lay information is readily available through electronic resources. However, there is no medical definition of the “MS hug” and no published information about how the term is used by people with MS.

Design/Methods Retrospective medical record review. Spontaneously reported “MS hug” symptoms were evaluated in conjunction with neurologic history, medical and neurology examination, MRI results, and other medical diagnoses. The “MS hug” was defined as a unilateral or bilateral segmental constricting (squeezing, band-like, or girdle-like) sensation involving the thorax, abdomen, or both that was associated with objective evidence of a neuroanatomically-appropriate current or prior spinal cord lesion and not attributable to another cause.

Results Of 116 people with MS (71% female; 76% relapsing disease) reporting the “MS hug”, 46 (41%) met the study definition. The onset of symptoms occurred during cord relapse evolution (41%), during early recovery (20%), or more than 3 months post-relapse or during the progressive phase (39%). Delayed-onset symptoms usually persisted and required treatment. Of the 70 patients whose symptoms did not meet the study definition, 27 had other types of neuropathic pain without a constricting sensation and 11 had no clear etiology. However, 32 (46%) had a clear alternative cause, most commonly musculoskeletal discomfort, GERD, anxiety, and bowel symptoms. Serious alternative causes requiring immediate intervention included herpes zoster (n=3), myocardial infarction, pulmonary embolism, and cholecystitis (n=1 each).

Conclusions The “MS hug” pattern of myelopathic sensory discomfort can develop during acute or chronic stages of MS-related cord injury. However, people with MS commonly misattribute symptoms, including those of serious medical conditions, to the “MS hug”. Patient and physician education are needed to avoid this error.

Authors/Disclosures
Dean M. Wingerchuk, MD, FAAN (Mayo Clinic) PRESENTER	Dr. Wingerchuk has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics. Dr. Wingerchuk has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Wingerchuk has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Meyer Squibb. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Wingerchuk has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca. Dr. Wingerchuk has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Wingerchuk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abcuro. Dr. Wingerchuk has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters Kluwers.
Cristina Valencia Sanchez, MD (Mayo Clinic Arizona)	Dr. Valencia Sanchez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG therapeutics. Dr. Valencia Sanchez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Valencia Sanchez has a non-compensated relationship as a member of the medical advisory board with The MOG Project that is relevant to AAN interests or activities.
Jonathan L. Carter, MD (Mayo Clinic)	Dr. Carter has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck Pharmaceuticals A/S. The institution of Dr. Carter has received research support from MedDay Pharmaceuticals . The institution of Dr. Carter has received research support from Roche Pharmaceuticals.

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