Patterns of pain presentation in multiple sclerosis

A suggested approach to the analysis of pain in MS is outlined in Box 24.1. It is intended to encourage the clinician to consider the pathophysiologic basis of the pain before considering which treatment modalities are most appropriate.Pains of primary neurogenic origin are divided into paroxysmal and nonparoxysmal. Paroxysmal pains may be more likely to respond to anticonvulsant drugs, whereas ongoing central pains may be more likely to respond to other groups of drugs such as anti-depressants and N-methyl-D-aspartic acid (NMDA) receptor antagonists, and in some cases opioids.

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