neuropathic pain - for Janet

April 30, 2003

Janet,

Neuropathic pain-see Dr. article below-is common with CMT

ARCHIVES OF PHYSICAL MEDICINE REHABILITATION December 1998, Volume

79, pages 1560-1564

GT, Jensen MP, Galer BS, Kraft GH, Crabtree LD, Beardsley RM,

Abresch RT, Bird TD

Department of Rehabilitation Medicine, University of Washington

School of Medicine, Seattle, USA.

OBJECTIVES: To determine the frequency and extent to which subjects

with Charcot-Marie-Tooth (CMT) disease report pain and to compare

qualities of pain in CMT to other painful neuropathic conditions.

STUDY DESIGN: Descriptive, nonexperimental survey, using a previously

validated measurement tool, the Neuropathic Pain Scale (NPS).

PARTICIPANTS: Participants were recruited from the membership roster

of a worldwide CMT support organization.

MAIN OUTCOME MEASURES: NPS pain descriptors reported in CMT were

compared with those reported by subjects with postherpetic neuralgia

(PHN), complex regional pain syndrome, type 1 (CRPS-1), also known as

reflex sympathetic dystrophy, diabetic neuropathy (DN), and

peripheral nerve injury (PNI).

RESULTS: Of 617 CMT subjects (40% response rate), 440 (71%) reported

pain. with the most severe pain sites noted as low back (70%), knees

(53%), ankles (50%), toes (46%), and feet (44%). Of this group, 171

(39%) reported interruption of activities of daily living by pain;

168 (38%) used non-narcotic pain medication and 113 (23%) used

narcotics and/or benzodiazepines for pain. The use of pain

description was similar for CMT, PHN, CRPS-1, DN, and PNI in terms of

intensity and the descriptors hot, dull, and deep.

CONCLUSIONS: Neuropathic pain is a significant problem for many

people with CMT. The frequency and intensity of pain reported in CMT

is comparable in many ways to PHN, CRPS-1, DN. and PNI. Further

studies are needed to examine possible pain generators and

pharmacologic and rehabilitative modalities to treat pain in CMT.

JD

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