Acute distal neuropathic pain in guillain-barré syndrome (GBS): a multicentre retrospective cohort study

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 94; no. Suppl 1; pp. A18 - A19
• Main Authors: Chan, Laura, O’Brien David, Bryden, Graham, Evans, Matthew, Ul Huda Syed Shehroz, Keh, Ryan, Devine, Helen, Carr, Aisling, Lavin, Tim
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.11.2023
• Subjects: Cohort analysis; Guillain-Barre syndrome; Pain
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/JNNP-2023-ABN.55

Pain is common in the acute phase in Guillain-Barré syndrome (GBS), affecting 66% in a large Dutch cohort, with 43% experiencing distal neuropathic pain in the first three weeks. We aimed to ascertain the frequency, and treatment of acute distal neuropathic pain in the first two weeks of admission of a multicentre UK GBS cohort.We performed a retrospective cohort study of incident GBS to 4 neuroscience centres December 2019 and April 2022. We collected data on demographics, GBS subtype, and the presence of distal limb neu- ropathic pain and its pharmacological management.47 patients were included, mean age 54.3yrs (SD 15.9), 64% male. 56% AIDP, 26% AMSAN/AMAN, or GBS variants. Mean mEGOS score was 5 (SD 3.4), mean length of stay 32.5 days (SD 25.7 days). 34% required ITU care, 23% required invasive ventilation.Neuropathic pain was experienced by 78.7% (37) of patients within the first 2 weeks, of which 70.2% (33) received at least 1 neuropathic pain agent. There was no correlation of the presence of neuropathic pain with GBS severity or subtype.There was a high frequency of acute neuropathic pain, compared to previous cohorts. 28.2% of patients were untreated, highlighting the importance of ongoing assessment.