Determination of pain and response to methylprednisolone in Guillain-Barré syndromeReportar como inadecuado

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Journal of Neurology

, 254:1318

First Online: 11 April 2007Received: 22 October 2006Revised: 29 November 2006Accepted: 03 December 2006


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.

MethodsGBS 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.

Results123 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.

ConclusionsPain 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 words Guillain-Barré syndrome pain symptoms, course methylprednisolone  Download fulltext PDF

Autor: Liselotte Ruts - Rinske van Koningsveld - Bart C. Jacobs - Pieter A. van Doorn


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