Prevalence and Pattern of Craniofacial Pain and Headache in Danish Patients with Neuromyelitis Optica Spectrum Disorder

Abstract

There is a dearth of knowledge about the pattern of pain and somatosensory alterations that co-exist with neuromyelitis optica spectrum disorder (NMOSD). Understanding the presence and underlying mechanisms will assist in better pain management in these patients. This study sought to identify prevalence and pattern of headache, craniofacial pain and abnormalities in somatosensory function within a group of NMOSD patients in Denmark. Six patients (two males, four females; mean age 41.2 ± 8.6 years) participated in a telephone interview. Eight questionnaires were used to assess pain, illness perception, fatigue, anxiety and depression. Pain occurred in several regions, including the head, face, neck, back and legs. Two patients experienced frequent headaches and one had headaches following neck pain. Pain occurred frequently over a 3-month period, ranging from mild to severe and described as ‘burning’ (66.7%), ‘exhausting’ (83.3%) and ‘sharp’ (50%). Correlations were found between pain severity and patients’ ‘ability to walk’ (r=0.889), ‘general activity’ (r=0.901), ‘mood’ (r=0.603), ‘normal work’ (r=0.664), ‘relations with other people’ (r=0.774) and ‘sleep’ (r=0.586). Somatosensory abnormality was only reported in legs. While fatigue had a great impact on patients’ daily life, patients did not report that for anxiety and depression. This study demonstrated that headaches and craniofacial pain occur frequently in NMOSD. Patients’ function, mobility, mood and sleep were all affected by pain. These findings highlight the value of further investigation on headaches, craniofacial and overall pain in NMOSD.

A Multisite and Multimodal Comparative Study of Cerebellar Connectome Between Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders

“…Several previous case studies have reported that NMOSD patients presented choreoathetosis or pseudoathetosis, a series of involuntary and irregular movements of the face, head, hand or limbs (Boddu and Shenker 2019; Seok, Jang, and You 2018; Sugeno 2013). In addition, headaches and craniofacial pain were reported in NMOSD patients (Nielsen et al 2018). Since cortical thinning typically reflects neuron loss and functional deficits, the thinner PMB is speculated to, at least partly, be responsible for these symptoms in NMOSD patients.…”