We examined the frequency and the type of pain syndromes in the published literature affecting MOGAD and NMOSD patients.

Neuromyelitis Optica Spectrum Disorder (NMOSD) and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disorders (MOGAD) are autoimmune inflammatory disorders that affect the central nervous system. Pain is considered one of the debilitating symptoms that is highly prevalent and severely impairs the quality of life; however, the frequency and type of pain among them are still underreported. 

PubMed and Google Scholar databases searches were done through October 14, 2025, according to the PRISMA guidelines, using the following keywords (pain, neuropathic pain, ocular pain, headache, nociceptive pain, painful tonic spasm, spasticity-associated pain, MOGAD, Anti-myelin oligodendrocyte glycoprotein antibody-associated disorders, Neuromyelitis Optica Spectrum Disorder, NMOSD. Fourteen studies were included in our analysis.

Five hundred fifty-eight patients were included in our analysis. Five hundred ten patients were diagnosed with NMOSD, while 48 patients were diagnosed with MOGAD. The mean age of the patients in the MOGAD group was 32.2 ± 18.3 years, while the mean age of the NMOSD patients was 48.6 ± 4.37 years. Neuropathic pain was more common in the NMOSD compared to MOGAD (71% vs 43% p=0.01). Headache was the most common pain syndrome among MOGAD patients compared to NMOSD (45.83% vs 9.6%, p =0.01). No statistical difference in spasticity related pain between both groups (19.8% vs 31.25 % p=0.06). Similarly, pain due to other causes, such as arthralgia (11.3% 4.1%, p=0.12).

Pain is a frequent symptom in NMOSD and MOGAD. Pain syndromes differ between NMOSD and MOGAD, with a higher prevalence of headache in MOGAD and higher neuropathic pain in NMOSD. Further research should concentrate on a multidisciplinary approach to pain management focused on the respective pain type.