I was reading on Dr. Kantor's Forum that MS lesions can cause pain. I am a little confused, even after being diagnosed since the 1990's. Can brain lesions actually cause pain?
I have pain everyday, all day. I was told by a Neurologist a long time ago, that my spinal lesion is the reason for my leg pain. I understand about the spasms in MS. I hate to sound really stupid here, but I did not know that brain lesions could cause pain. Is it because of the nerves they may affect? Especially ones in the brain stem.
Perhaps someone with more experience than me, can help me to understand what Dr. Kantor said, "that MS lesions cause pain." I really thought the pain we experience is pain somewhere along the nerve's path that is affected by a lesion.
Can anyone help this thick headed lady with MS to understand this in laymen's terms? Thanks in advance.
Feeling really stupid for asking this. You'd think I would know this after so many years of having MS.
Good question! Since pain is really a kind of sensation, I wonder if you can get it like a paresthesia so the problem could start anywhere the signal gets messed up, either before or after it hits the brain??? I really don't know, though, so I hope someone else does.
Here are a couple interesting articles on MS and different types of pain:
1. Musculoskeletal Pain (from weakness, spasticity or imbalance so I guess indirectly caused by MS)
2. Paroxysmal Pains (that come and go). Here they give the examples of trigeminal neuralgia and L'hermittes sign (altho it sort of seem to me these also fit under 3)
3. Neuropathic Pain: "constant, boring, burning or tingling intensely ... Paraesthesias include pins and needles; tingling; shivering; burning pains; feelings of pressure; and areas of skin with heightened sensitivity to touch. The pains associated with these can be aching, throbbing, stabbing, shooting, gnawing, tingling, tightness and numbness."
which ends with a very interesting paragraph about MS pain and hypnosis:
"Kraft, meanwhile, has recently begun a study looking at a very different approach to MS pain: hypnosis. 'It's well known that there is a 'gating' mechanism in the higher cognitive parts of the brain to let signals come through to the consciousness. There can be all kinds of mischief in the pain fibers in the spinal cord, but it has to get through to the cortex before it's painful,' he says. 'With hypnosis, we hope to block or at least reduce the interpretation of that stimulus as a painful stimulus. It looks promising so far, and obviously it doesn't have the problem of medication side effects.'"
There's also what looks like an interesting article at
http://www.ncbi.nlm.nih.gov/pubmed/17928147 if anyone can get hold of it.
sho (who's hoping someone else knows the real answer)
First, Dr. Kantor said "MS" lesions can cause pain. "Brain" lesions are only one place where MS can cause lesions. Typically you think of pain and paresthesias as being from spinal lesions and brainstem lesions.
But, lesions in the brain also mess around with the overall pathways of the snsory pain nerves. There would be no reason to think that pain or a paresthesia couldn't arise from some MS lesions.
Sho brings up a good point about the theory of "gating" in MS. Definitely lesions in the brain could affect the gating reponse in the cortex.
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