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July 1983

Chronic Pain Syndrome in Amyotrophic Lateral Sclerosis

Author Affiliations

From the Division of Neurology, Department of Medicine, Duke University Medical Center, Durham, NC. Dr Drake is now with the Department of Neurology, Ohio State University, Columbus.

Arch Neurol. 1983;40(7):453-454. doi:10.1001/archneur.1983.04050070083025

Amyotrophic lateral sclerosis (ALS) is classically a disease of motor neurons and has clinical manifestations involving the motor system, although cramps may occur.1 Paresthesias are frequently described, particularly at the onset of weakness and muscular atrophy.2 Chronic pain has not been reported in this disorder, to my knowledge. Motor neuron disease may be associated with dementia, parkinsonism, or other neurologic disorders,3 and pathologic involvement extending beyond the motor system has been reported, particularly in the posterior column pathways.4 This report concerns a patient with clinically and electromyographically typical ALS in whom a concomitant chronic central pain syndrome developed, for which no additional cause could be found.

REPORT OF A CASE  Weakness, atrophy, and fasciculations of the left lower extremity developed in a 54-year-old woman in 1979. In 1980 she underwent lumbar laminectomy without relief of symptoms. Weakness, wasting, and fasciculations subsequently progressed in the left

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