Manejo del dolor en un caso de neuromielitis óptica (enfermedad de Devic)

Abstract

Neuromyelitis optica (NMO) or Devic's disease is an autoimmune disorder, inflammatory and demyelinating, which mainly affects the optic nerve and spinal cord. The clinical is characterized by neuropathic pain type, pattern of vision loss and the appearance of positive visual phenomena as phosphenes induced movement. In active lesions it has been demonstrated that there is pain amplification excitatory action essentially by excessive levels of glutamate. In established injury, loss of astrocytes represents the generality of pain. Devic's disease is more frequent and severe than in MS and has a serious impact on daily life. There literature refers isolated carbamazepine results. In this case report clearly shows the analgesic effect with decreased and painful spasms of neuromodulators + carbamazepine strong opioids in combination with psychotherapy to reduce levels of anxiety and depression and achieve a comprehensive pain management.