Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan.
Neuropsychiatr Dis Treat. 2013;9:1023-8. doi: 10.2147/NDT.S47014. Epub 2013 Jul 29.
Transverse myelitis is a rare inflammatory myelopathy characterized by loss of motor and sensory function below the affected level of the spinal cord, and causes neurogenic bowel and bladder. Occasionally, it also causes neuropathic pain with spasticity. Traditional therapies for neuropathic pain are multiple, including multimodal analgesic regimens, antiepileptic or antidepressant medications, opioids, sympathetic blocks, and spinal cord stimulation. Persistent neuropathic pain can cause emotional distress by affecting sleep, work, recreation, and emotional well-being. Here we report the case of a patient suffering from intractable neuropathic pain following acute transverse myelitis that was not relieved by combinations of nonsteroidal anti-inflammatory, anti-epileptic, antidepressant, and opioid medications, or by acupuncture. Implantation of an intrathecal morphine pump controlled the pain successfully without side effects, and enabled the patient to embark on intensive rehabilitation. The patient's muscle strength has improved significantly and the patient may soon be able to use a walker with minimal assistance.
横断性脊髓炎是一种罕见的脊髓炎症性疾病，其特征是脊髓受影响以下部位的运动和感觉功能丧失，并导致神经性肠和膀胱。偶尔，它也会引起痉挛性的神经性疼痛。传统的神经性疼痛治疗方法有多种，包括多模式镇痛方案、抗癫痫或抗抑郁药物、阿片类药物、交感神经阻滞和脊髓刺激。持续性神经性疼痛会通过影响睡眠、工作、娱乐和情绪健康而导致情绪困扰。在这里，我们报告了一例急性横断性脊髓炎后发生难治性神经性疼痛的患者，该患者的疼痛不能通过非甾体抗炎药、抗癫痫药、抗抑郁药和阿片类药物的联合治疗，或通过针灸来缓解。鞘内吗啡泵的植入成功地控制了疼痛，没有副作用，并使患者能够开始强化康复治疗。患者的肌肉力量有了显著改善，患者可能很快就能在最小的帮助下使用助行器。
