Tegretol for pain in the Guillain-Barré syndrome

Interêt de la corticothérapie dans le traitement de la douleur à la phase aiguë du syndrome de Guillain-Barré

INTRODUCTION

Pain is a common problem in both adults and children with Guillain-Barré Syndrome (GBS). Corticosteroids are rarely used in the treatment of pain in the course of GBS, although some authors have pointed out their value for the treatment of neuropathic pain. We report four patients with GBS whose pain was rapidly relieved by administration of corticosteroids.

METHODS

We reviewed retrospectively a series of four patients with GBS seen from September 2001 to February 2003. All patients had plexual (Case 3), trunkular (case 1), radicular (case 2) or focal (case 4) pain. Pain was treated with corticosteroids via oral (cases 1 and 2) or intravenous routes (cases 3 and 4). Corticoids where used after failure of other analgesic agents.

RESULTS

Pain relief was obtained after the first administration and persisted even after tapering off steroid treatment. No particular complication was observed during treatment course.

CONCLUSION

Our experience suggests that controlled studies should be set up to evaluate the place of corticosteroid treatment for the management of pain in patients with GBS.

Pain in the Guillain-Barré syndrome: a clinical review

The Guillain-Barré syndrome, or acute inflammatory polyneuropathy, is often regarded as a predominantly motor neuropathy with few sensory features, which has a good prognosis in most cases. However, pain is a common symptom occurring in up to 72% of cases. The types of pain are protean including paraesthesiae, dysaesthesia, axial and radicular pain, meningism, myalgia, joint pain and visceral discomfort, etc., and patients may present in a variety of clinical settings such as intensive care units, acute medical wards or rehabilitation departments. These factors, combined with the fact that the condition is relatively uncommon, means that no controlled trial of pain management has been done and a range of treatments has been proposed. We review the various pains which may be associated with Guillain-Barré syndrome and discuss suggestions for their management.

The Guillain-Barré syndrome in intensive care

The history, clinical presentation and pathological findings of the Guillain-Barré Syndrome are presented. An analysis is made of patients with this syndrome admitted to an intensive care ward over a six year period. Results and management are discussed.