Kajimoto Madoka, Koga Michiaki, Narumi Hiroko, Inoue Hirofumi, Matsushige Takeshi, Ohga Shouichi
Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Japan.
Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate School of Medicine, Japan.
Brain Dev. 2015 Oct;37(9):897-900. doi: 10.1016/j.braindev.2015.01.004. Epub 2015 Feb 15.
A 10-year-old boy was diagnosed as having the axonal form of Guillain-Barré syndrome (GBS). The patient noticed progressive weakness of the lower legs on the 1st day of illness. Intravenous immunoglobulin therapy was immediately started on the 2nd day of illness. Despite the favorable recovery of muscle weakness, he complained of severe needle-like pain in the thighs and buttocks and also painful numbness over the gastrocnemius regions. Acetaminophen and hydroxyzine therapy was ineffective for the pain control. Oral prednisolone therapy (0.7 mg/kg/day) led to drastic pain-relief with favorable improvement of the weakness. Corticosteroid therapy is not typically used in the management of GBS patients. Although GBS-associated pain frequently occurs in children, only a few reports have indicated the analgesic utility of steroids in the treatment of pediatric GBS. This observation may suggest the alternative of this therapy as for the as the limited, but potentially rapid, control of GBS-associated acute radicular pain in pediatric patients.
一名10岁男孩被诊断为患有轴索性吉兰-巴雷综合征（GBS）。患者在发病第一天就注意到小腿逐渐无力。在发病第二天立即开始静脉注射免疫球蛋白治疗。尽管肌无力恢复良好，但他仍抱怨大腿和臀部有严重的针刺样疼痛，以及腓肠肌区域的疼痛性麻木。对乙酰氨基酚和羟嗪治疗对疼痛控制无效。口服泼尼松龙治疗（0.7mg/kg/天）使疼痛大幅缓解，肌无力也得到良好改善。皮质类固醇疗法通常不用于GBS患者的治疗。虽然与GBS相关的疼痛在儿童中经常发生，但只有少数报告指出类固醇在治疗儿童GBS方面的镇痛作用。这一观察结果可能表明，对于儿科患者中有限但可能迅速的GBS相关急性神经根性疼痛控制，这种疗法是一种替代方法。
