A NEW SYMPTOM IN NEUROLOGY: NEUROPATHIC POST-EJACULATORY PAIN IN NMO

Background Transverse myelitis (TM) associated with neuromyelitis optica (NMO) has many unusual characteristics compared with TM in Multiple Sclerosis (MS): long centrally located lesions that cause significant motor-sensory (including tonic spasms) and autonomic dysfunction. We wish to report a symptom not previously described in neurological literature, neuropathic post ejaculatory pain (PEP). Methods We will present videos of 3 male patients with AQP4-IgG +ve NMO describing post-ejaculatory pain (PEP). Results All patients were recovering from long thoracic TM and had autonomic dysfunction at nadir. None had preexisting urological symptoms. The pain occurred immediately after orgasm and ejaculation and was severe, brief ( Conclusion PEP has not been described in neurological disorders and maybe a unique feature of NMO associated myelitis.