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November 1983

Lightning Pains in Ankylosing Spondylitis: Response to Carbamazepine

Author Affiliations

Department of Neurology Hospital Provincial de Madrid Doctor Esquerdo, 46 Madrid-30 Spain

Arch Neurol. 1983;40(12):771. doi:10.1001/archneur.1983.04050110089021

To the Editor.  —Lightning pains occur in about one third of all patients with the cauda equina syndrome of ankylosing spondylitis.1 Though no therapy—including laminectomy—is effective, pains may be relieved by carbamazepine.

Report of a Case.  —A 69-year-old man was admitted to the hospital because of severe pain in the legs. By age 20 years, persistent pain and stiffness in the lower part of the back had developed, leading to fixed kyphosis and reduced mobility of the spine. Shooting pains in the legs appeared two years prior to admission and became incapacitating. They were paroxysmal and brief and occurred particularly at night. The pain was located in well-defined skin loci, one on the right heel and another on a clearly separated spot on the dorsolateral aspect of the right foot. Bouts of pain could occur either simultaneously in both areas or separately in just one. Rarely, a paroxysm occurred

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