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

## TL;DR

Satralizumab may help reduce severe pain and spasms in neuromyelitis optica spectrum disorder when other treatments fail.

## Contribution

This case report provides evidence that satralizumab can alleviate refractory pain and spasms in NMOSD.

## Key findings

- A patient with NMOSD experienced significant improvement in pain and spasms after starting satralizumab.
- Conventional treatments failed to adequately manage the patient's symptoms.
- Satralizumab shows potential as an alternative therapy for refractory NMOSD pain and spasms.

## Abstract

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.