Asaro Joseph, Robinson Christine A, Levy Philip T
Department of Pediatrics, Goryeb Children's Hospital, Atlantic Health System, Morristown, NJ, USA.
Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy at Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
Child Neurol Open. 2017 Feb 10;4:2329048X17693123. doi: 10.1177/2329048X17693123. eCollection 2017 Jan-Dec.
Visceral hyperalgesia refers to increased pain sensation in response to gastrointestinal sensory stimulus. In neonates with neurological impairments, gabapentin has been successfully used as a treatment for visceral hyperalgesia in neonates. The authors describe a preterm infant with myelomeningocele and persistent neuropathic pain that manifested as irritability, hypertonicity, poor weight gain, and feeding intolerance. After exclusion of other etiologies, the diagnosis of visceral hyperalgesia was suspected and the infant was treated with gabapentin. Following appropriate titration to effect and close monitoring of side effects of gabapentin, he subsequently demonstrated improved tone, decreased irritability with feedings, and appropriate weight gain. In addition, the authors provide a review of the available literature of gabapentin use in neonates and offer suggestions on when to consider starting gabapentin in a neonate with neurological impairment and chronic unexplained gastrointestinal manifestations.
内脏痛觉过敏是指对胃肠道感觉刺激产生的疼痛感觉增强。在患有神经功能障碍的新生儿中，加巴喷丁已成功用于治疗新生儿内脏痛觉过敏。作者描述了一名患有脊髓脊膜膨出和持续性神经性疼痛的早产儿，其表现为易激惹、肌张力亢进、体重增加不佳和喂养不耐受。在排除其他病因后，怀疑为内脏痛觉过敏，并对该婴儿使用加巴喷丁进行治疗。在对加巴喷丁进行适当的剂量滴定以达到疗效并密切监测其副作用后，他随后表现出肌张力改善、喂养时易激惹减轻以及体重适当增加。此外，作者对加巴喷丁在新生儿中的现有文献进行了综述，并就何时考虑对患有神经功能障碍和慢性不明原因胃肠道表现的新生儿开始使用加巴喷丁提出了建议。
