NEW HAVEN, Conn., Apr 10 (Reuters Health)--A large-scale survey of more than 7,000 multiple sclerosis (MS) patients shows that most MS patients are undertreated and often unrecognized for pain management.
Yale University neurologist Dr. Marco Rizzo presented these findings last week here at the 15th Yale Neuroimmunology Symposium.
"MS patients experience migraine headaches, eye, leg, facial, bladder and skin pain. Muscular spasms and [prickling or tingling sensations of the skin] are common, and the pain is chronic," Rizzo explained.
MS is a central nervous system disorder in which the thin protective coating called myelin that insulates nerve fibers in the brain and spine becomes damaged. Eventually, lesions develop in the brain and spinal cord that can lead to a loss of vision, weakness, numbness and tingling.
MS occurs when white blood cells known as T cells attack the proteins that make up myelin. Currently, there is no cure for the disease.
Chronic pain causes "miswiring," leading to abnormal pain pathways, Rizzo noted. Typical pain medications do not work in chronic pain and so MS patients need to be treated with medications such as a class of antidepressants known as tricyclic antidepressants, and anticonvulsants.
Typically, more than
one medication or combination needs to be given in order to effectively
tackle the pain, Rizzo pointed out. Some of the medications Rizzo finds
to be effective are gabapentin (Neurontin), lamotrigine (Lamictal), amitriptyline,
the broad-spectrum anticonvulsant (divalproex) Depakote, topirimate (Topamax)
and baclofen. OxyContin, a new opiate, has shown no results in managing
chronic MS pain, according to Rizzo.
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