Pain in Guillain-Barré syndrome.
OBJECTIVE
To determine the character, intensity and frequency of pain in Guillain-Barré syndrome (GBS) and to evaluate the response to treatment.


METHODS
A prospective longitudinal study.


METHODS
Academic hospital-based practices.


METHODS
Fifty-five consecutive patients with GBS.


METHODS
Patients were evaluated on admission and at 2, 4, 8, 16, and 24 weeks.


METHODS
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.
Moulin
D E
DE
Department of Clinical Neurological Sciences, London Health Sciences Centre, Ontario, Canada.
Hagen
N
N
Feasby
T E
TE
Amireh
R
R
Hahn
A
A
D001415:Back; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D011129:Polyradiculoneuropathy / Q000503:physiopathology*
D009294:Narcotics; D009020:Morphine