Prevalence Survey Of Painful Tonic Spasms In 116 Patiens With Idiopathic Inflammatory Demyelinating Diseases Of The Central Nervous System

Objective To investigate the prevalence rate of painful tonic spasms in patiens with Idiopathic Inflammatory Demyelinating Diseases (IIDDs) of the Central Nervous System and to analyse its clinical worth by a retrospective review.Methods According to the paper"consensus of experts about the diagnosis and the treatment of Multiple Sclerosis and related central nervous system demyelinating diseases in China"by the Chinese Medical Association of neuropathy in 2006 and"the clinical progress of Idiopathic Inflammatory Demyelinating Diseases"by QI Xiaokun in 2008,a retrospective survey was performed at department of neurology in our hospital from March 2008 to December 2009. The prevalence of painful tonic spasms rate was analysed in statistics and the results were contrasted between different classification whether there was any statistical difference. Furthermore,the sensitivity, specificity and predictive value for each sub-groups were calculated,and the limbs and pathogenic lesions suffered from painful tonic spasms regularly were calculated to observe its clinical worth.Results (1)In this study, 116 patients with IIDDs were included. Among them, patients with painful tonic spasms were 13 cases.And the prevalence rate of painful tonic spasms was 11.2% in IIDDs. The prevalence rate of painful tonic spasms in the subgroup of 31 patients with Multiple sclerosis (MS) was 12.9%. The prevalence rate of painful tonic spasms in 16 patients with Neuromyelitis Optica (NMO) was 18.8%.And the other prevalence rate was 0% and 9.5% individually in 6 patients with Acute Disseminated Encephalomyelitis (ADEM) and 63 patients with Clinical Isolated Syndromes (CIS).There was no statistical difference about the prevalence rate of painful tonic spasms in different subgroups among MS,NMO and CIS. (2) In order to analyse the clinical value of painful tonic spasms to the diagnosis of IIDDs, the sensitivity, specificity and predictive value were calculated for each subgroup.The results showed that the sensitivies of all subgroups were small.But all the specificity of them were very larger.(3)The limbs suffered from painful tonic spasms were statistically analysed to show that both lower extremities and all limbs were more commonlly,and both the ratio came to 30.8%.And the incidence of painful tonic spasms associated with pathogenic lesions.The cervical and thoracic spinal cord were more likely sufferd according to the data,and both the ratio came to 38.5%.Conclusion (1) Our data showed that the prevalence rate of painful tonic spasms was 11.2% in IIDDs. There was no significant difference about the prevalence rate of painful tonic spasms in different subgroups among MS,NMO and CIS. (2) Our data showed that there was some value about painful tonic spasms for the diagnosis of IIDDs.Although their sensitivities were very low,their specificities were very high.That is to say,with painful tonic spasms,there are more chances to get the disease of IIDDs.3)Our data showed that both lower extremities and all limbs were more commonlly suffered from painful tonic spasms.And the incidence of painful tonic spasms associated with pathogenic lesion in the Central Nervous System (CNS).The cervical and thoracic spinal cord were more likely sufferd from painful tonic spasms,although the lesions involved could exist either inside or outside the spinal cord in the CNS.