Determination of pain and response to methylprednisolone in Guillain-Barré syndrome
- Liselotte RutsAffiliated withDept. of Neurology, Erasmus MC, Room number Ee-2230 Email author
- , Rinske van KoningsveldAffiliated withDept. of Neurology, Erasmus MC
- , Bart C. JacobsAffiliated withDept. of Neurology, Erasmus MC
- , Pieter A. van DoornAffiliated withDept. of Neurology, Erasmus MC
Pain can be a serious problem in patients with Guillain-Barré syndrome (GBS). Different pain symptoms and the effect of methylprednisolone on pain are evaluated.
GBS patients were recruited from a randomized placebo-controlled study comparing intravenous immunoglobulin (IVIg) + methylprednisolone (500 mg for 5 days) versus IVIg + placebo. Presence and severity of pain were prospectively scored at randomization and after 4 weeks. Efficacy of methylprednisolone was evaluated using endpoints: percentage of patients with pain and percentage of patients improving in pain-severity level. Medical records of the subgroup of patients treated in the Erasmus MC were screened retrospectively for different pain symptoms and course. Pain was scored at different time intervals: within 4 weeks before randomization and 0–2, 2–4, 4–24, 24–52 weeks after randomization.
123 (55%) of 223 patients had pain at randomization. In 70%, pain already started before onset of weakness. Methylprednisolone did not show a positive effect on the presence and reduction of pain. In the subgroup of 39 patients, backache (33%), interscapular (28%), muscle (24%), radicular pain (18%) and painful par-/dysaesthesiae (18%) were most frequently present within the period of 4 weeks before randomization. Twenty-six percent had extreme pain 0–2 weeks after randomization. Most symptoms of pain decreased after this period, but painful par-/dysaesthesiae and muscle pain often remained present during at least 6 months.
Pain frequently occurs, often starts before onset of weakness and may cause severe complaints. Especially painful par-/dysaesthesiae and muscle pain may persist for months. Methylprednisolone seems to have no significant effect on the presence and intensity of pain.
Key wordsGuillain-Barré syndrome pain symptoms, course methylprednisolone
- Determination of pain and response to methylprednisolone in Guillain-Barré syndrome
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of Neurology
- Online Date
- April 2007
- Print ISSN
- Online ISSN
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- Guillain-Barré syndrome
- pain symptoms, course
- Industry Sectors
- Author Affiliations
- 2. Dept. of Neurology, Erasmus MC, Room number Ee-2230, P.O. BOX 1738, 3000 DR, Rotterdam, The Netherlands
- 1. Dept. of Neurology, Erasmus MC, Rotterdam, The Netherlands