Background and aims: Multiple sclerosis is a chronic, inflammatory and degenerative disease of the central nervous system, which manifest in a wide range of syndromes. One of these syndromes is pain syndrome. But it is rarely considered as a first symptom of MS. However, when collecting a medical history, many patients are referring to pain syndromes that arise in the time frame of the probable beginning of the disease.
Methods: Cross-sectional study conducted in neurology department of Lviv Regional Clinical Hospital. 93 patients with MS have passed a clinical examination and standardized questionnaires (PainDetect, SF-MPQ-2, BPI, DN4, HADS, SF-36).
Results: 79 (84,9%) of patients said that they had pain syndromes over the last month before examination. 43 patient (46,3%) indicated pain syndromes as a first manifestation of the MS. 26 (28%) of them had neuropathic or mixed pain syndromes as a first manifestation of the disease.  Among them  15(16,1%) patients had ongoing extremity pain, 4 (4,3%) had Lhermitte’s phenomenon, 2 (2,2%) trigeminal neuralgia and 5 (5,4%) painful tonic spasms. 17 (18,3%) patients had pain that, according to classification that we have used, could be interpreted as nociceptive. Including 13 (14%) patients with headache (in most of cases it does not meet the primary headache criteria), 2 (2,15%) with back pain and 2 (2,15%)  with pain associated with optic neuritis. For 31 (33,3%) patients pain was the most disturbing symptom. In patients with pain, according to HADS questionnaire, depression and anxiety levels where higher. 
Conclusions: Pain is common syndrome in MS and has large influence on patients quality of life. As a first manifestation of the MS pain syndromes are also quite frequent. But mostly neither doctors nor patients associate them with the disease. This is especially true of nociceptive pain syndromes such as headache, back pain and others, which can often also be the first manifestation , but they are more difficult to associate with MS. Taking in consideration pain syndrome as a possible manifestation of MS will improve early detection of patients with MS.Сreation of new specific questionnaire and classification will help clinicians with these patients. Objectification of subjective sensation of pain in multiple sclerosis with mathematical analysis and such modern technologies as fMRI will improve understanding, diagnostics and treatment of these conditions and, as a consequence, patients quality of life.

01 - PAIN AS A FIRST AND ONE OF THE MOST DISTURBING SYMPTOMS OF MULTIPLE SCLEROSIS