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Types of pain in NMOSD patients including painful tonic muscle spasms, neuropathic pain, and sometimes pain due to excess loading and pain as a side effect of immunotherapy and in the context of comorbidities. Also, 46% of NMOSD patients in the current study experienced ongoing pain, and further binary logistic regression analysis showed that pain was positively correlated with the C5a level, with gender and EDSS score were identified as independent factors. Keywords: neuromyelitis optica spectrum disorders; remission; pain; C5a EN neuromyelitis optica spectrum disorders remission pain C5a 1039 1046 8 06/09/22 20220501 NES 220501 Introduction Neuromyelitis optica spectrum disorders (NMOSD) is a rare autoimmune inflammatory demyelinating disease of the central nervous system (CNS) characterized by recurrent inflammation of the optic nerve, spinal cord, and specific brain areas.[1] Compared to multiple sclerosis (MS) that primarily targets myelin, NMOSD induces irreparable neuronal cell death which leads to more severe disability and a poorer prognosis.[2] The clinical presentation of NMOSD includes severe episodes of optic neuritis that may lead to loss of vision, transverse myelitis causing paraplegia or paralysis, and sometimes brainstem encephalitis causing intractable vomiting or hiccups. Pain, which is highly prevalent in patients with NMOSD, can greatly impair quality of life.[18] In the present study, 46% of the patients with NMOSD during remission complained of current pain. [Extracted from the article]