Abstract Details

Title Neurogenic Pain in Multiple Sclerosis: A Single Center Comprehensive Pain Assessment

Topic Multiple Sclerosis

Presentation(s) S54 - Multiple Sclerosis: Disease Progression, Disease-modifying Therapy, and Clinical Considerations (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Objective Our focus was the development of a new pain assessment form to facilitate patient communication, quantify the location and types of pain, identify the pain medications and track patient outcomes.

Background Robust literature shows 30-85% of Multiple Sclerosis (MS) patients have reported various types of neurogenic pain. MS-related neurogenic pain is often coincident with muscle aches, spasms, joint issues, and other non-neurogenic sources.

Design/Methods This is a single-center prospective survey project to characterize MS-related pain. We developed a new assessment that allows patients to differentiate neurogenic from non-neurogenic pain, identify the type of pain they experience, and indicate specific locations and intensity of their pain. The new form utilizes both traditional 1-10 scales and pictographic representation for both neurogenic and non-neurogenic pain. Demographics, therapeutics, and management are also recorded.

Results We collected data from May, 2017 to October, 2019 on 70 MS patients (mean age 61.3 years, 78.5% female) experiencing neurogenic pain. Of the 70 patients, average pain score is 7.6±1.8 (range of 2-10), with all showing frequent pain and 3 to 4 types of neurogenic pain along with non-neurogenic pain. Severity of neurogenic pain types ranged from 6.0 to 7.6 with dysesthesias and electrical pain the most intense. Overall, opioid use is low (n=13) with the AEDs, gabapentin, pregabalin and oxcarbazepine utilized in the majority of patients (n=51). This information is utilized to facilitate further management and as a baseline for longitudinal assessments.

Conclusions

The design and utilization of this form in the clinical setting have definitively facilitated a meaningful patient/physician discussion of pain. In addition, it has highlighted the high levels of pain, the use of AEDs, and that pain control is often suboptimal. Utilization of this form in follow up visits and tracking the data longitudinally creates a significant potential to optimize therapies for individual patients.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
M. M. Paz Soldan, MD, PhD (University of Utah)	Dr. Paz Soldan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Paz Soldan has received research support from National Institutes of Health. The institution of Dr. Paz Soldan has received research support from National Multiple Sclerosis Society. The institution of Dr. Paz Soldan has received research support from Western Institute for Biomedical Research. The institution of Dr. Paz Soldan has received research support from Biogen. The institution of Dr. Paz Soldan has received research support from Novartis. The institution of Dr. Paz Soldan has received research support from Clene Nanomedicine.
	No disclosure on file
Ka-Ho Wong (U of U Neurology Clinic)	The institution of Mr. Wong has received research support from The Sumaira Foundation . The institution of Mr. Wong has received research support from The Siegel Rare Neuroimmune Association.
John W. Rose, MD, FAAN (Imaging and Neurosciences Center)	The institution of Dr. Rose has received research support from National Multiple Sclerosis Society. The institution of Dr. Rose has received research support from Guthy Jackson Charitable Foundation. The institution of Dr. Rose has received research support from NIH . The institution of Dr. Rose has received research support from VA. The institution of Dr. Rose has received research support from Biogen. The institution of Dr. Rose has received research support from Friends of MS. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care.

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