Matsuo Junichi, Nakahara Keiichi, Hara Yasuyuki, Ueda Mitsuharu
Neurology, Kumamoto Rosai Hospital, Yatsushiro, JPN.
Neurology, Kumamoto University, Kumamoto, JPN.
Cureus. 2025 Jun 19;17(6):e86335. doi: 10.7759/cureus.86335. eCollection 2025 Jun.
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.
视神经脊髓炎谱系障碍（NMOSD）常伴有严重的中枢神经性疼痛和痛性强直性痉挛，而针对这些症状的治疗选择有限。萨特利珠单抗是一种靶向白细胞介素-6受体的人源化单克隆抗体，已降低了抗水通道蛋白4抗体阳性NMOSD患者的复发率。尽管有报告表明萨特利珠单抗可能减轻与NMOSD相关的中枢神经性疼痛和痛性强直性痉挛，但尚无确凿证据。在此，我们描述了一名NMOSD患者，其难治性中枢神经性疼痛和痛性强直性痉挛对传统治疗反应不佳，但在开始使用萨特利珠单抗后有明显改善。该病例表明，萨特利珠单抗可能对与NMOSD相关的中枢神经性疼痛和痛性强直性痉挛有效，并且在其他治疗无效时可能是一种替代疗法。
