Background Pruritis (itch) is primarily a dermatologic problem. ‘Neurogenic pruritus’ (NP) has been described in some neurological diseases including MS and in a case with neuromyelitis optica spectrum disorder (NMOSD). Though the physiology of NP is uncertain ascending pathways or central processing could be involved.

Aim To assess the characteristics of NP in NMOSD patients.

Method Retrospective case note review followed by prospective telephone/clinic interviews of all AQP4 positive patients who attended National NMO clinic after 1 January 2011.

Results 14/45 patients reported significant pruritus during the course of NMO and were interviewed. After excluding patients with only optic neuritis or an obvious skin/systemic cause 12 (26.7%) had NP occurring within a median of 3(0–90) months from onset of NMO. The median severity on visual analogue score was 6 (2–9). In three cases pruritus developed at a median of 5 (2–28) days before onset of motor-sensory symptoms of transverse myelitis (TM); most of the remaining patients developed it within 1 month after the onset of TM. A long cervical cord lesion was seen in 9 of 12 cases and correlated well with the dermatomal distribution of NP.

Conclusions NP seems to be a common symptom associated with the TM of NMOSD.