M Saulino1. 1. Moss Rehab., Department of Rehabilitation Medicine, Thomas Jefferson University, Elkins Park, PA, USA.
Abstract
STUDY DESIGN: Case report. OBJECTIVES: To report a novel management strategy for neuropathic pain management after spinal cord injury. SETTING: Outpatient spinal cord injury (SCI) clinic. METHODS: The patient demonstrated two neuropathic pain syndromes, namely at- and below-level pain. These syndromes were recalcitrant to conservative measures and a decision was made to proceed with intrathecal therapies. RESULTS: The patient's at-level pain was responsive to intrathecal hydromorphone but the below-level pain was unaffected by this intervention. Intrathecal ziconotide provided an opposite response with a positive effect observed on the below-level pain and minimal effect on the at-level pain. The combination of intrathecal ziconotide and hydromorphone provided effective relief for both components of the patient's SCI associated neuropathic pain. CONCLUSIONS: The combination of intrathecal ziconotide and hydromorphone has the potential to provide significant pain relief for patients with neuropathic pain associated with spinal cord injury.
STUDY DESIGN: Case report. OBJECTIVES: To report a novel management strategy for neuropathic pain management after spinal cord injury. SETTING:Outpatientspinal cord injury (SCI) clinic. METHODS: The patient demonstrated two neuropathic pain syndromes, namely at- and below-level pain. These syndromes were recalcitrant to conservative measures and a decision was made to proceed with intrathecal therapies. RESULTS: The patient's at-level pain was responsive to intrathecal hydromorphone but the below-level pain was unaffected by this intervention. Intrathecal ziconotide provided an opposite response with a positive effect observed on the below-level pain and minimal effect on the at-level pain. The combination of intrathecal ziconotide and hydromorphone provided effective relief for both components of the patient's SCI associated neuropathic pain. CONCLUSIONS: The combination of intrathecal ziconotide and hydromorphone has the potential to provide significant pain relief for patients with neuropathic pain associated with spinal cord injury.
Authors: Sara M Oliveira; Cássia R Silva; Gabriela Trevisan; Jardel G Villarinho; Marta N Cordeiro; Michael Richardson; Márcia H Borges; Célio J Castro; Marcus V Gomez; Juliano Ferreira Journal: Pflugers Arch Date: 2016-02-22 Impact factor: 3.657