El dolor en el síndrome de Guillain - Barré ¿un síntoma subtratado?
DOI:
https://doi.org/10.28957/rcmfr.v25n2a7Palabras clave:
Síndrome de Guillain - Barré, dolor musculo esquelético, dolor neuropático, opioides, gabapentinoides.Resumen
El síndrome de Guillain - Barré (SGB) es una polirradiculoneuropatía de inicio agudo y progresión rápida, caracterizada en ocasiones por desmielinización y en otras por daño axonal primario (inflamatorio-tóxico) en gran parte reversible, que afecta principalmente los nervios motores, aunque también puede afectar los nervios sensitivos1. Alcanza su intensidad máxima dentro de cuatro semanas con debilidad, arreflexia, afectación de pares craneales y hasta falla ventilatoria, el tratamiento se realiza con inmunoglobulina intravenosa (Ig IV) o con plasmaféresis, es una patología que en todas sus variantes puede causar un dolor agudo y crónico.
Se presenta el caso de una paciente de 53 años con un SGB variante, neuropatía axonal motora y sensitiva aguda (AMSAN) y dolor lumbar y neuropático secundario, se relata su tratamiento médico y una revisión de la literatura del tratamiento del dolor en SGB.
Referencias bibliográficas
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11. Kokubun N, Nishibayashi M, Uncini A, Odaka M, Hirata K, Yuki N. Conduction block in acute motor axonal neuropathy. Brain. 2010;133(10):2897-908.
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13. Feasby TE. Axonal Guillain-Barré syndrome. Muscle Nerve. 1994;17(6):678-9.
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6e63656469726563742e636f6d$$/science/article/pii/S217358081500108X.
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of Psychiatrists. [internet]. Reino Unido: British Pain Society; 2013. [Actualizado dia del mes del año, citado dia del mes del año]. Disponible en: https://www.britishpainsociety.org/british-pain-society-publications/professional-publications/2013.
27. Moulin D, Boulanger A, Clark AJ, Clarke H, Dao T, Finley GA, et al. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Res Manag. 2014;19(6):328-35.
2. Moulin DE, Hagen N, Feasby TE, Amireh R, Hahn A. Pain in Guillain-Barré syndrome. Neurology. 1997;48(2):328-31.
3. Dimachkie MM, Barohn RJ. Guillain-Barré syndrome and variants. Neurol Clin. 2013;31(2):491-510.
4. Ansar V, Valadi N. Guillain-Barré syndrome. Prim Care. 2015;42(2):189-93.
5. Van Doorn PA. Diagnosis, treatment and prognosis of Guillain-Barré syndrome (GBS). Presse Med. 2013;42(6 Pt 2):e193-201.
6. Feasby TE, Gilbert JJ, Brown WF, Bolton CF, Hahn AF, Koopman WF, et al. An acute axonal form of Guillain-Barré polyneuropathy. Brain. 1986;109 ( Pt 6):1115-26.
7. McKhann GM, Cornblath DR, Griffin JW, Ho TW, Li CY, Jiang Z, et al. Acute motor axonal neuropathy: a frequent cause of acute flaccid paralysis in China. Ann Neurol. 1993;33(4):333-42.
8. Kuwabara S, Yuki N. Axonal Guillain-Barré syndrome: concepts and controversies. Lancet Neurol. 2013;12(12):1180-8.
9. Griffin JW, Li CY, Ho TW, Tian M, Gao CY, Xue P, et al. Pathology of the motor-sensory axonal Guillain-Barré syndrome. Ann Neurol. 1996;39(1):17-28.
10. Ho TW, Mishu B, Li CY, Gao CY, Cornblath DR, Griffin JW, et al. Guillain-Barré syndrome in northern China. Relationship to Campylobacter jejuni infection and anti-glycolipid antibodies. Brain. 1995;118 (Pt 3):597-605.
11. Kokubun N, Nishibayashi M, Uncini A, Odaka M, Hirata K, Yuki N. Conduction block in acute motor axonal neuropathy. Brain. 2010;133(10):2897-908.
12. Bril V, Katzberg HD. Acquired immune axonal neuropathies. Continuum (Minneap Minn). 2014;20(5 Peripheral Nervous System Disorders):1261-73.
13. Feasby TE. Axonal Guillain-Barré syndrome. Muscle Nerve. 1994;17(6):678-9.
14. Ruts L, Drenthen J, Jongen JL, Hop WC, Visser GH, Jacobs BC, et al. Pain in Guillain-Barre syndrome: a long-term follow-up study. Neurology. 2010;75(16):1439-47.
15. Rekand T, Gramstad A, Vedeler CA. Fatigue, pain and muscle weakness are frequent after Guillain-Barré syndrome and poliomyelitis. J Neurol. 2009;256(3):349-54.
16. Umapathi T, Yuki N. Pain in Guillain-Barré syndrome. Expert Rev Neurother. 2011;11(3):335-9.
17. Gorson KC. This disorder has some nerve: chronic pain in Guillain- arre syndrome. Neurology. 2010;75(16):1406-7.
18. Bernsen RA, Jager AE, Schmitz PI, van der Meché FG. Long-term sensory deficit after Guillain-Barré syndrome. J Neurol. 2001;248(6):483-6.
19. Martinez V, Fletcher D, Martin F, Orlikowski D, Sharshar T, Chauvin M, et al. Small fibre impairment predicts neuropathic pain in Guillain-Barré syndrome. Pain. 2010;151(1):53-60.
20. Jo YS, Han SD, Choi JY, Kim IH, Kim YD, Na SJ. A case of acute motor and sensory axonalneuropathy following hepatitis a infection. J Korean Med Sci. 2013;28(12):1839-41.
21. Pain management in Guillainâ“Barre syndrome: A systematic review 2015 [internet]. Bogotá: Pontifica Universidad Javeriana; [Actualizado en dia mes del año; citado en dia mes del año]. Disponible en: https://bases.javeriana.edu.co/f5-w-687474703a2f2f7777772e73636965
6e63656469726563742e636f6d$$/science/article/pii/S217358081500108X.
22. Roca B, Mentero A, Simón E. Pain and opioid analgesics in Guillain-Barré syndrome. Neurology. 1998;51(3):924.
23. Liu J, Wang LN, McNicol ED. Pharmacological treatment for pain in Guillain-Barré syndrome. Cochrane Database Syst Rev. 2013;10:CD009950.
24. Pandey CK, Bose N, Garg G, Singh N, Baronia A, Agarwal A, et al. Gabapentin for the treatment of pain in guillain-barré syndrome: a double-blinded, placebo- controlled, crossover study. Anesth Analg. 2002;95(6):1719-23, table of contents.
25. McDouall SF, Tasker RC. Are anticonvulsants a satisfactory alternative to opiate analgesia in patients experiencing pain with Guillain-Barre syndrome? Arch Dis Child. 2004;89(7):686-7.
26. 2013 TBPsI. Opioids for persistent pain: Good practice. A consensus statement prepared on behalf of the British Pain Society, the Faculty of Pain Medicine of the Royal College of Anaesthetists,the Royal College of General Practitioners and the Faculty ofAddictions of the Royal College
of Psychiatrists. [internet]. Reino Unido: British Pain Society; 2013. [Actualizado dia del mes del año, citado dia del mes del año]. Disponible en: https://www.britishpainsociety.org/british-pain-society-publications/professional-publications/2013.
27. Moulin D, Boulanger A, Clark AJ, Clarke H, Dao T, Finley GA, et al. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Res Manag. 2014;19(6):328-35.
Cómo citar
1.
Hoyos Gutiérrez JB, Leal Arenas FA, Antolinez AM. El dolor en el síndrome de Guillain - Barré ¿un síntoma subtratado?. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 18 de febrero de 2016 [citado 19 de abril de 2024];25(2):156-62. Disponible en: https://revistacmfr.org/index.php/rcmfr/article/view/147
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