Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease.
BACKGROUND
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is the most common neurodegenerative disorder of the motor system in adults. Pain in ALS is a frequent symptom especially in the later stages of disease and can have a pronounced influence on quality of life and suffering. Treatment of pain therefore should be recognised as an important aspect of palliative care in ALS.


OBJECTIVE
To systematically review the evidence for the efficacy of drug therapy in relieving pain in ALS. We also aimed to evaluate possible adverse effects associated with the different drugs and their influence on survival and quality of life.


METHODS
The authors searched the following databases: the Cochrane Neuromuscular Disease Group Trials Register (October 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 1), MEDLINE (January 1966 to October 2007), EMBASE (January 1980 to October 2007), CINAHL (January 1982 to October 2007), AMED (January 1985 to October 2007) and LILACS (January 1982 to October 2007). We checked the bibliographies of trials identified and contacted other disease experts to identify further published and unpublished trials.


METHODS
We searched for randomised or quasi-randomised controlled trials on drug therapy for pain in amyotrophic lateral sclerosis.


METHODS
Data were collected using a specially designed form and analysed using the Cochrane Review Manager software.


RESULTS
No randomised or quasi-randomised controlled trials on drug therapy for pain in ALS or MND were found.


CONCLUSIONS
There is no evidence from randomised controlled trials about the management of pain in ALS. Further research on this important aspect of palliative care in ALS is needed. Randomised controlled trials should be initiated to determine the effectiveness of different analgesics for treatment of pain in ALS.
Brettschneider
Johannes
J
Neurology, University of Ulm, Oberer Eselsberg 45, Ulm, Germany, 89081. johannesbrettschneider@web.de
Kurent
Jerome
J
Ludolph
Albert
A
Mitchell
J Douglas
JD
D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D006801:Humans; D016472:Motor Neuron Disease / Q000150:complications; D010146:Pain / Q000188:drug therapy*