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Intractable Neuropathic Pain in COVID-19-Induced Guillain-Barré Syndrome: A Case Report
Stephen Ritter1, Daniel Gable1, Andrew May1
1Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, USA.
Cureus
|April 24, 2023
Summary
This case study details neuropathic pain in a COVID-19 patient with Guillain-Barré syndrome. A multidisciplinary approach, including amitriptyline, effectively managed severe pain and psychological symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Pain Management
Background:
- Limited literature exists on neuropathic pain in COVID-19-induced acute inflammatory demyelinating polyneuropathy (AIDP).
- COVID-19 is associated with Guillain-Barré syndrome (GBS), including its Miller-Fisher variant.
Observation:
- A vaccinated 20-year-old female with COVID-19 presented with headache and diplopia, diagnosed with Miller-Fisher variant GBS.
- The patient experienced severe, 10/10 burning pain and allodynia during intensive care unit stay.
Findings:
- A multimodal pain regimen including narcotics, neuropathic medications, and topical agents was initiated.
- Rehabilitation psychology consultation supplemented behavioral pain management with pharmacological strategies.
- Amitriptyline demonstrated optimal response, aiding in co-treatment of psychological manifestations and pain.
Implications:
- This case highlights the potential severity of COVID-19-induced AIDP and neuropathic pain.
- A multidisciplinary approach is crucial for managing complex pain and psychological symptoms in these patients.
- Further research into COVID-19's neurological sequelae and effective pain management strategies is warranted.
