November 1986

Epidural Morphine Treatment of Pain in Guillain-Barré Syndrome

Author Affiliations

From the Departments of Anesthesiology/ Critical Care Medicine (Drs Rosenfeld, Borel, and Hanley) and Neurology and Neurosurgery (Drs Borel and Hanley), The Johns Hopkins Medical Institutions, Baltimore.

Arch Neurol. 1986;43(11):1194-1196. doi:10.1001/archneur.1986.00520110080023

The discovery of specific opiate receptors in the spinal cord and brain formed the anatomic rationale for the subsequent use of both epidural and intrathecal narcotics to control pain.1 The efficacy of spinally administered narcotics in treating postoperative and chronic pain conditions is widely accepted.2 The pain in these chronic disorders is usually caused by tissue compression, or neural invasion from either primary or metastatic neoplasms. There are no reports in the literature about the efficacy of spinally administered narcotics in the treatment of the pain associated with inflammatory peripheral neuropathies. We describe a patient with Guillain-Barré syndrome who had severe dysesthetic pain unresponsive to routine analgesics and other therapeutic maneuvers, who was successfully managed with epidural morphine sulfate.

REPORT OF A CASE  A 20-year-old man with no known previous medical problems, presented with three days of increasing weakness of his extremities associated with paresthesias. He was

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