The analgesic effect of intravenous methylprednisolone on acute neuropathic pain with allodynia due to central cord syndrome: a retrospective study

Abstract

BackgroundCentral cord syndrome (CCS) may be associated with severe neuropathic pain that often resists to conventional pain therapy regimens and affects the patients’ quality of life (QoL) seriously. Current treatments for CCS-associated neuropathic pain have limited evidence of efficacy. This retrospective study was performed to present the effects of early treatment with methylprednisolone (MP) on acute neuropathic pain relief and the QoL in CCS patients.Patients and methodsData were collected from the medical records of CCS patients who suffered from acute neuropathic pain with allodynia. All the patients received intravenous MP treatment for up to 1 week. Patients were evaluated with standard measures of efficacy: neuropathic pain intensity, the area of allodynia, and the QoL at baseline, daily treatment, and at 1 and 3 months after the end of MP treatment.ResultsThirty-four eligible patients were enrolled in our study. By the end of MP treatment, the proportion of patients who gained total or major (visual analog scale [VAS] score decreased by 50% or more) allodynia relief from the treatment was 91.18%, and a decrease in spontaneous pain was also observed. Moreover, this study showed MP could significantly improve the QoL of patients based on McGill Pain Questionnaire Short Form and EuroQol Five Dimensions Questionnaire. Four patients (11.76%) during MP treatment experienced mild or moderate side effects. None of the patients manifested CCS-associated neuropathic pain recurrence and MP-associated side effects at follow-up.ConclusionThe current results suggested that MP offered an effective therapeutic alternative for relieving CCS-associated acute neuropathic pain with allodynia. Given the encouraging results of this study, it would be worthwhile to confirm these results in randomized placebo-controlled clinical trials.

Comparison of Efficacy and Safety of Duloxetine and Nonsteroidal Anti-inflammatory Drugs in Subacromial Impingement Syndrome

“…We used an adverse-effects checklist interview to collected duloxetine and NSAIDs related side effects during and after treatment. (32) The possible side effects include somnolence; nausea; peptic ulcer; dizziness; headache; vomiting; stomatitis; decreased appetite; constipation; dry mouth; hyperhidrosis; hypertension; insomnia; dysuresia; diarrhea; ventosity. (18) Data Analysis…”

Central Neuropathic Mechanisms in Pain Signaling Pathways: Current Evidence and Recommendations

“…In patients with neuropathic pain secondary to traumatic injury causing central cord syndrome refractory to conventional analgesics, a group of orthopedists in China examined the effect of treatment with methylprednisolone on acute neuropathic pain [ 59 ]. In a small sample of 34 patients that was not placebo controlled, patients received seven methylprednisolone infusions daily for 1 week [ 59 ]. Allodynia relief exceeding 50% was seen in 91% of patients during the 3-month follow-up period [ 59 ].…”

“…In a small sample of 34 patients that was not placebo controlled, patients received seven methylprednisolone infusions daily for 1 week [ 59 ]. Allodynia relief exceeding 50% was seen in 91% of patients during the 3-month follow-up period [ 59 ]. A separate hypothesis included a small, 13-subject, placebo-controlled study that used intrathecal baclofen as an intervention to improve neuropathic pain.…”