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Methylprednisolone worsening neuropathic pain in non-traumatic thoracic myelopathy.
Wu, Y-T; Chiang, S-L; Lai, M-H; Lu, S-C; Chang, C-C; Chang, S-T.
Afiliación
  • Wu YT; Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Neihu District, Taipei, Taiwan.
J Clin Pharm Ther ; 35(4): 491-6, 2010 Aug.
Article en En | MEDLINE | ID: mdl-20831552
ABSTRACT
Methylprednisolone (MP) is the only neuroprotective medication currently in widespread use for the treatment of spinal cord injury. Increasingly, published studies challenge its clinical effects in view of its serious side-effects including wound infection, pneumonia, sepsis and steroid myopathy. Most cases with spontaneous spinal epidural haematoma (SSEH) need emergency evacuation, and typically show good neurologic recovery. Some patients with SSEH given preoperative or postoperative MP within hours of the onset of symptoms, and have had good motor recovery, although no mention was made of sensory function. Severe, intractable neuropathic pain has not been reported in patients with SSEH. We present a case of SSEH treated with a high-dose MP 16 h after onset of symptoms. Surgical decompression was performed 1 h after MP treatment. Motor recovery was good; however, intractable neuropathic pain developed 5 weeks postoperatively. We discuss the factors contributing to intractable pain. We speculate that the severe, intractable pain might be due to misuse of large-dose steroids in this case of non-traumatic spinal myelopathy, and not because of the injury per se.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades de la Médula Espinal / Metilprednisolona / Antiinflamatorios / Neuralgia Tipo de estudio: Etiology_studies Límite: Adult / Humans / Male Idioma: En Revista: J Clin Pharm Ther Asunto de la revista: FARMACIA / TERAPEUTICA Año: 2010 Tipo del documento: Article País de afiliación: Taiwán

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Enfermedades de la Médula Espinal / Metilprednisolona / Antiinflamatorios / Neuralgia Tipo de estudio: Etiology_studies Límite: Adult / Humans / Male Idioma: En Revista: J Clin Pharm Ther Asunto de la revista: FARMACIA / TERAPEUTICA Año: 2010 Tipo del documento: Article País de afiliación: Taiwán