Visceral Hyperalgesia: When to Consider Gabapentin Use in Neonates-Case Study and Review

Area of Science:

• Neonatal neurology
• Gastroenterology
• Pharmacology

Background:

• Visceral hyperalgesia involves heightened pain perception from gastrointestinal stimuli.
• Neurological impairments in neonates can exacerbate visceral hyperalgesia.
• Gabapentin is a potential therapeutic agent for neonatal visceral hyperalgesia.

Purpose of the Study:

• To describe the successful use of gabapentin in a preterm infant with myelomeningocele and visceral hyperalgesia.
• To review the literature on gabapentin use for visceral hyperalgesia in neonates.
• To provide guidance on initiating gabapentin therapy in neonates with neurological impairments and gastrointestinal issues.

Main Methods:

• Case report of a preterm infant with myelomeningocele presenting with neuropathic pain symptoms.
• Diagnosis of visceral hyperalgesia after excluding other causes.
• Treatment with gabapentin, including titration and side effect monitoring.
• Literature review of gabapentin in neonatal visceral hyperalgesia.

Main Results:

• The infant experienced improved muscle tone, reduced irritability during feedings, and achieved appropriate weight gain.
• Gabapentin was successfully titrated to therapeutic effect with no significant adverse events.
• Literature supports gabapentin's utility in managing neonatal neuropathic pain and visceral hyperalgesia.

Conclusions:

• Gabapentin is a viable treatment option for visceral hyperalgesia in neonates with neurological impairments.
• Careful monitoring and titration are essential for safe and effective gabapentin use in this population.
• Early consideration of gabapentin may benefit neonates with unexplained chronic gastrointestinal symptoms and neurological deficits.