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February 01, 1997; 48 (2) Article

Pain in Guillain-Barre syndrome

D. E. Moulin, N. Hagen, T. E. Feasby, R. Amireh, A. Hahn
First published February 1, 1997, DOI: https://doi.org/10.1212/WNL.48.2.328
D. E. Moulin
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N. Hagen
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T. E. Feasby
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R. Amireh
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A. Hahn
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Citation
Pain in Guillain-Barre syndrome
D. E. Moulin, N. Hagen, T. E. Feasby, R. Amireh, A. Hahn
Neurology Feb 1997, 48 (2) 328-331; DOI: 10.1212/WNL.48.2.328

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Abstract

Article abstract-Objectives: To determine the character, intensity and frequency of pain in Guillain-Barre syndrome (GBS) and to evaluate the response to treatment. Design: A prospective longitudinal study. Setting: Academic hospital-based practices. Patients: Fifty-five consecutive patients with GBS. Interventions: Patients were evaluated on admission and at 2, 4, 8, 16, and 24 weeks. Main outcome measures: Character of pain, pain intensity using Visual Analogue Scale ([VAS] 0 to 10 cm) and Present Pain Intensity of McGill Pain Questionnaire, pain relief (VAS 0 to 10 cm), Disability Grading Scale for GBS. Results: Forty-nine patients (89.1%) described pain during the course of their illness. On admission, mean pain intensity (VAS) was 4.7 +/- 3.3. However, 26 patients (47.3%) described pain that was either distressing, horrible, or excruciating (mean VAS, 7.0 +/- 2.0). The most common pain syndromes observed were deep aching back and leg pain and dysesthetic extremity pain. Pain intensity on admission correlated poorly with neurologic disability on admission (r = 0.26, p = 0.06) and throughout the period of study (r < 0.20, p > 0.10). Forty-one patients (74.5%) required opioid analgesics, with 16 (29.0%) receiving parenteral morphine to provide adequate pain relief. Conclusions: Moderate to severe pain is a common and early symptom of GBS and requires aggressive treatment. Pain intensity on admission is not a predictor of poor prognosis. Back and leg pain usually resolves over the first 8 weeks, but dysesthetic extremity pain may persist longer in 5 to 10% of patients despite motor recovery and the use of adjuvant analgesics.

NEUROLOGY 1997;48: 328-331

  • Copyright 1997 by Advanstar Communications Inc.
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