Satralizumab Ameliorates Refractory Central Neuropathic Pain and Painful Tonic Spasms in Neuromyelitis Optica Spectrum Disorder: A Case Report.

Neuromyelitis optica spectrum disorder (NMOSD) is frequently accompanied by severe central neuropathic pain and painful tonic spasms for which therapeutic options are limited. Satralizumab, a humanized monoclonal antibody targeting the interleukin-6 receptor, has reduced relapse rates among patients with anti-aquaporin-4 antibody-positive NMOSD. Although reports have suggested that satralizumab may reduce NMOSD-associated central neuropathic pain and painful tonic spasms, conclusive evidence does not yet exist. Herein, we describe a patient with NMOSD whose refractory central neuropathic pain and painful tonic spasms did not adequately respond to conventional treatments but markedly improved following the initiation of satralizumab. This case suggests that satralizumab may be effective for central neuropathic pain and painful tonic spasms associated with NMOSD and could be an alternative therapy when other treatments are ineffective.