Bülent GÜVEN, Hayat GÜVEN, Eylem SAYILGAN, Fatma AVŞAR ÖZTÜRK

Multipl Skleroz Hastalarında Ağrı ve İlişkili Klinik Özellikler

Amaç: Multipl skleroz (MS) ağrılı bir hastalık olarak kabul edilmemekle birlikte, MS hastalarında ağrılı semptomlarla sık olarak karşılaşılır. Buçalışmada MS hastalarında çeşitli tipteki ağrıların ve bu ağrılarla ilişkili klinik özelliklerin araştırılması amaçlanmıştır.Gereç ve Yöntem: Tekrarlayan-düzelen MS (RRMS) tanısıyla izlenmekte olan 70 ardışık hasta çalışmaya alındı. Hastaların demografik ve kliniközellikleri, genişletilmiş özürlülük durum ölçeği (EDSS) puanları, beyin ve spinal kort demyelinizan plakları kaydedildi. Çalışmaya alınan hastalardamigren, gerilim tipi baş ağrısı (GTBA), tedaviyle ilişkili baş ağrısı, Lhermitte bulgusu, nöropatik ekstremite ağrısı, ağrılı tonik spazmlar, bel ağrısı vemekanik nedenli ekstremite ağrıları araştırıldı. Ayrıca hastalar yorgunluk, depresyon ve anksiyete semptomları açısından değerlendirildi.Bulgular: Çalışmaya alınan 70 hastanın (54 kadın, 16 erkek; yaş ortalaması 36,2±7,9) 64’ünün (%91,4) bir veya daha fazla ağrılı duruma sahipoldukları saptandı. Bel ağrısı en sık görülen ağrılı semptom olarak bulundu (%48,6). Bunu sırasıyla migren (%38,6), tedavi ile ilişkili baş ağrısı (%31,1)izliyordu. Migreni olan MS hastalarında, migreni olmayanlara göre yorgunluk, depresyon ve anksiyete semptomlarının daha sık olduğu saptandı(sırasıyla, p=0,027, p=0,01 ve p=0,016). Nöropatik ekstremite ağrısı olanlarda MS hastalık süresi daha uzun idi (p=0,018). Nöropatik ekstremiteağrısı, Lhermitte bulgusu ve bel ağrısı olan hastaların daha yüksek EDSS puanlarına sahip oldukları bulundu (sırasıyla, p

Pain in Patients with Multiple Sclerosis and Associated Clinical Characteristics

Objectives: Even though multiple sclerosis (MS) is not considered to be a painful disease, painful symptoms are frequently encountered in patients with MS. The objective of this study was to investigate various types of pain and clinical features associated with these pains in patients with MS. Materials and Methods: Seventy consecutive patients followed up with relapsing remitting MS were included in the study. Besides demographic and clinical characteristics of patients, expanded disability status scale (EDSS) scores, cranial and spinal demyelinating lesions were recorded. Patients were investigated for migraine, tension-type headache (TTH), treatment-related headache, Lhermitte sign, neuropathic limb pain, painful tonic spasms, low back pain, and mechanical limb pain, and also evaluated for associated fatigue, depression and anxiety symptoms. Results: Of the 70 patients (54 females, 16 males, mean age 36.2±7.9) 64 had one or more painful disorders (91.4%). Low back pain was the most common painful symptom (48.6%) followed by migraine (38.6%) and treatment-related headache (31.1%). Fatigue, depression and anxiety were found to be more frequently in patients with migraine than in those without migraine (p=0.027, p=0.01 and p=0.016, respectively). The duration of MS was longer in patients with neuropathic pain (p=0.018). Patients with neuropathic limb pain, Lhermitte sign, and low back pain had higher EDSS scores (p

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