PO063 Utility of mri in central and peripheral neuropathic pain (np)

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Abstract

Introduction

There is little information on the usefulness of MRI in the management of NP. We prospectively compared its contribution to the management of patients with and without NP.

Methods

Patients (n=81):Mean age 56±14. PNS (n=40) (32 polyneuropathies,8 focal PNS), CNS (n=25) and combined CNS and PNS disease (n=16), each subdivided as painful (NP+) or painless (NP-). NP+ (n=59),NP- (n=22). MRI (n=81) Siemmens Symphony 1.5T, brain and whole spine.

MRI classification

Concordant: diagnostic/consistent with the initial clinical diagnosis.

MRI classification

Discordant: findings not pathologically significant, unexpectedly normal, or unsuspected significant pathology found related or unrelated to the neurological diagnosis. Fisher´s exact test to compare proportions.

Results

Concordant MRIs (n=62): NP +79%, NP- 77% (p=1.0); proportions of NP +and NP- not significantly different within the PNS, CNS and CNS and PNS groups. Discordant MRIs (n=26): NP +30.5% NP-36.3% (p=0.8); proportions also not significantly different within the above groups. 13 (50%) showed significant unsuspected pathology (10 NP+, 3 NP-). MRI changed the initial anatomopathological diagnosis in 11/81 patients (13.5%) (8 NP+, 3 NP-).

Conclusions

22% of patients with neuropathic pain had complex pathology involving both the PNS and CNS. The diagnostic yield of MRI was similar in NP+and NP- patients. Neurological and MRI assessments are essential for patients with neuropathic pain as for patients with similar but painless pathology.

*Funding

Fondecyt1120339

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