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Pain Management

Gilliam Barre Pain

10/31/2008

Question:

My daughter had Gilliam Barre almost two years ago. She was in intensive care for three weeks and received plasmaphoresis as a successful treatment. She went through rehab to regain strength in her legs as she was unable to walk at the time. She is now fully recovered except for ongoing pain and numbness in her feet. She tried a couple nerve pain medications and eventually our family doctor just gave her Vicodin. She is 19 and I am looking for any information to treat this condition. Is there a "cure" or more beneficial treatment we could try. It is very difficult to find information on the long-term effects of Gilliam Barre.

Answer:

Your daughter likely has "neuropathic" pain, a pain type due to nerve damage. Neuropathic pain may respond better to certain medications that work on nerves like the antiseizure medications and antidepressant medications. Not all antiseizure medications and antidepressant medications work for neuropathic pain. Preferred medications include Lyrica or Gabapentin (Neurontin) from among the antiseizure medications and Cymbalta from antidepressant medications. Sometimes Tramadol, a pain medicine with antidepressant like properties, is used successfully (in place of Cymbalta) as an "as needed" medication. Unlike narcotics (Vicodin), these drugs are not potentially habit forming and no tolerance builds up in response to using them.

Alternatively, other interventions may be used if the above fails. It is important that your daughter sees pain specialists who care for neuropathic pain in a multidisciplinary setting such as found at University Hospitals of Cleveland, Case Medical Center.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University