Qin-Ying Li1, Bei Wang2, Jun Yang3, Lei Zhou4, Jingzi Zhang Bao4, Liang Wang4, An-Jing Zhang5, Chi Liu6, Chao Quan7, Fang Li8. 1. Department of Rehabilitation Medicine, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai 200040, China. 2. Department of Neurology, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai 200040, China. 3. Department of Rehabilitation Medicine, Zhangdian District People's Hospital, Zibo City, Shandong Province, 255000, China. 4. Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China. 5. Department of Neurological Rehabilitation Medicine, The First Rehabilitation Hospital of Shanghai, Kongjiang Branch, Shanghai 200093, China. 6. Department of Geriatrics Center, Jing'an District Centre Hospital of Shanghai, Fudan University, Shanghai 200040, China. 7. Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China. Electronic address: chao_quan@fudan.edu.cn. 8. Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Rehabilitation Medicine, Renhe Hospital, Baoshan District, Shanghai, 200431, China. Electronic address: fangl@fudan.edu.cn.
Abstract
OBJECTIVES: Painful tonic spasm (PTS) is a common symptom in patients with neuromyelitis optica spectrum disorder (NMOSD). We herein aimed to explore the prevalence, subtype, and features of PTS in Chinese Han patients with NMOSD. METHODS: We retrospectively reviewed medical records and interviewed patients with NMOSD who were admitted to Huashan Hospital and the Jing'an District Center Hospital of Fudan University in Shanghai, China, from February 2017 to May 2019. The primary questionnaires included a Numerical Rating Scale (NRS), Spinal Cord Injury Health Questionnaire (SCI-HQ), Penn Spasm Frequency Scale (PSFS), and Patient Global Impression of Improvement (PGI-I). RESULTS: Sixty-seven of 153 (43.79%) patients with NMOSD showed PTS, only when spinal cord was involved. PTS had a negative impact on daily life in 97.01% (65/67) of the patients, and 92.54% (62/67) of the patients needed symptomatic treatment. Pain intensity and frequency of PTS were significantly different (P = 0.018 with NRS, P = 0.045 with PSFS) among flexor tonic spasm, extensor tonic spasm, isometric tonic spasm and complex tonic spasm subtype. Forty patients (59.71%) manifested complex tonic spasms, which indicated more severe pain and frequent spasms comparing to other subtypes. The locations of PTS were significantly different among the 5 subtypes (P<0.001), i.e.,77.78% (7/9) of flexor tonic spasms appeared in the upper extremity, 100% (9/9) of extensor tonic spasm occurred in the lower extremity, and isometric tonic spasms principally occurred in the trunk (87.5%). Forty-one patients (66.13%) demonstrated good responses to the symptomatic treatments, and there were no statistical differences with respect to the therapeutic responses among the 5 PTS subtypes (P = 0.509). CONCLUSIONS: PTS was associated with myelitis, and was a common symptom in NMOSD. Intensity, frequency and location were different among the PTS subtypes. Complex tonic spasm was the most common and serious subtype.
OBJECTIVES:Painful tonic spasm (PTS) is a common symptom in patients with neuromyelitis optica spectrum disorder (NMOSD). We herein aimed to explore the prevalence, subtype, and features of PTS in Chinese Han patients with NMOSD. METHODS: We retrospectively reviewed medical records and interviewed patients with NMOSD who were admitted to Huashan Hospital and the Jing'an District Center Hospital of Fudan University in Shanghai, China, from February 2017 to May 2019. The primary questionnaires included a Numerical Rating Scale (NRS), Spinal Cord Injury Health Questionnaire (SCI-HQ), Penn Spasm Frequency Scale (PSFS), and Patient Global Impression of Improvement (PGI-I). RESULTS: Sixty-seven of 153 (43.79%) patients with NMOSD showed PTS, only when spinal cord was involved. PTS had a negative impact on daily life in 97.01% (65/67) of the patients, and 92.54% (62/67) of the patients needed symptomatic treatment. Pain intensity and frequency of PTS were significantly different (P = 0.018 with NRS, P = 0.045 with PSFS) among flexor tonic spasm, extensor tonic spasm, isometric tonic spasm and complex tonic spasm subtype. Forty patients (59.71%) manifested complex tonic spasms, which indicated more severe pain and frequent spasms comparing to other subtypes. The locations of PTS were significantly different among the 5 subtypes (P<0.001), i.e.,77.78% (7/9) of flexor tonic spasms appeared in the upper extremity, 100% (9/9) of extensor tonic spasm occurred in the lower extremity, and isometric tonic spasms principally occurred in the trunk (87.5%). Forty-one patients (66.13%) demonstrated good responses to the symptomatic treatments, and there were no statistical differences with respect to the therapeutic responses among the 5 PTS subtypes (P = 0.509). CONCLUSIONS: PTS was associated with myelitis, and was a common symptom in NMOSD. Intensity, frequency and location were different among the PTS subtypes. Complex tonic spasm was the most common and serious subtype.
Authors: Andrea Salazar-Camelo; Naveen George; Hesham Abboud; Sarah M Planchon; Marcelo Matiello; Maureen A Mealy; Andrew Goodman Journal: J Neurol Date: 2021-09-05 Impact factor: 4.849