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Yıl:2021; Cilt: 58; Sayı: 3>> Özet
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Nöropsikiyatri Arşivi; 2021;58(3):213-216
Multiple Sklerozda Nöropatik Ekstremite Ağrısının Değerlendirilmesi
E Ata, TÖ Ünübol, S Demir
Sultan Abdülhamid Han Eğitim ve Araştırma Hastanesi
Amaç: Nöropatik ekstremite ağrısı Multiple sklerozda (MS) en sık görülen semptomlardan biridir. Bu çalışmada MS alt tiplerinde görülen nöropatik ağrının sıklığı ve şiddetini değerlendirip karşılaştırmak amaçlanmıştır. Yöntem: MS tanısı ile başvuran hastalar ardışık olarak çalışmaya dâhil edilmiştir. Klinik ve demografik verileri kayıt edilmiştir. Ağrıyı değerlendirmek için Vizuel Analog Skala (VAS) kullanılmıştır. Nöropatik ağrının değerlendirilmesi için hastalara LANSS ağrı skalası ile 4 soru nöropatik ağrı anketi (DN4) uygulanmıştır. Genişletilmiş özürlülük durumu ölçeği ile dizabilite değerlendirilmiştir. Bulgular: Çalışmaya 103 hasta dahil edilmiş olup bunların %82, 5’inde relapsing-remitting (RR) tip MS mevcuttu. LANSS ve DN4’e göre hastaların %47,6’sında nöropatik ağrı mevcuttu. Kadın hastaların ağrı skorları anlamlı derecede yüksekti. MS alt tipleri arasında nöropatik ağrı varlığı açısından anlamlı farklılık saptanmadı. Sekonder progresif (SP) MS alt tipinde hastaların EDSS skroları anlamlı derecede yüksekti. EDSS skoru ile hastalık süresi arasında anlamlı pozitif korelasyon mevcuttu. Sonuç: MS alt tipi fark etmeksizin MS’de nöropatik ağrı sıklıkla görülmektedir. SP MS’li hastaların EDSS skorları ve hastalık süreleri daha yüksektir ve bu iki parametre birbiri ile koreledir. MS tanısı alan tüm hastalar nöropatik ağrı açısından değerlendirilmelidir.
Evaluation of Neuropathic Extremity Pain in Patients with Multiple Sclerosis
Introduction: Neuropathic extremity pain is one of the most common symptoms of multiple sclerosis (MS). This study was aimed to evaluate and compare the frequency and severity of neuropathic extremity pain in subtypes of MS. Methods: Patients with the diagnosis of MS were included in the study, consecutively. Patients’ demographic and clinical data were recorded. Patients’ pain severity was assessed with visual analog scale (VAS). For the evaluation of neuropathic pain Leeds assessment of neuropathic symptoms and signs (LANSS) and douleur neuropathique 4 questions (DN4) were used. Disability was assessed with the Extended Disability Status Scale (EDSS). Results: One hundred and three patients were included and 82.5% of them had relapsing-remitting (RR) MS. According to LANSS and DN4, 47.6% of patients had neuropathic pain. Female patients had significantly higher pain scores. There was no significant difference between the subtypes of MS based on having neuropathic pain. Patients with seconder progressive (SP) MS had significantly higher EDSS. A significant positive correlation was detected between EDSS score and duration of disease. Conclusion: Regardless of the MS subtype patients had neuropathic pain. Patients with SP had significantly higher disease duration and EDSS which were correlated with each other. All patients with the diagnosis of MS should be evaluated for neuropathic pain.

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