Pain in multiple sclerosis

Acute and chronic pain syndromes are common in multiple sclerosis (MS). Rec ent surveys indicate that the prevalence of pain is up to 83%. About 20-25% of the patients experience pain as an early symptom of the disease. Typica l acute pain syndromes are trigeminal neuralgia, paroxysmal extremity pain, and painful tonic seizures. Optic neuritis can produce retroorbital pain. Furthermore chronic pain syndromes like continuous dysesthetic pain or pain ful leg spasms have considerable impact on the quality of life in the cours e of MS. Chronic extremity pain probably represents an injury to the centra l pain pathways. Paroxysmal pain syndromes usually respond to anticonvulsan t agent like carbamazepine or phenytoin. Eye pain caused by optic neuritis can be relieved with corticosteroids. For the treatment of chronic dysesthe tic extremity pain and painful leg spasm different therapeutic strategies w ith varying therapeutic evidence exists, but this type of pain is most diff icult to treat. This article gives an overview about the various pain syndr omes observed in MS and current treatment approaches.