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Headache and Pain in Guillain-Barré Syndrome

  • Secondary Headache (M Robbins, Section Editor)
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Abstract

While moderate and severe back or extremity pain is frequent in Guillain-Barré syndrome (GBS), headache appears to be uncommon. Most of the reports of headache in GBS place it in the context of the posterior reversible encephalopathy syndrome (PRES) which is increasingly recognized as a likely dysautonomia-related GBS complication. There are also a few reports of headache in the setting of increased CSF pressure and papilledema and in association with the Miller Fisher GBS variant. In comparison, back and extremity pain is highly prevalent. Aching muscle pain and neuropathic pain are the two most common of several pain types. Pain may be a heralding feature and has been described in patients as long as 2 years after disease onset. Pain management is a major axis of treatment in GBS. Gabapentin is a reasonable first-line choice, and opioid medications can be added for more severe pain but there are few clinical trials to inform specific recommendations. While the understanding of pain pathophysiology in GBS is incomplete, its prevalence and clinical impact are increasingly recognized and studied. Pain should be considered a cardinal manifestation of GBS along with acute, mostly symmetric weakness and diminished reflexes.

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Conflict of Interest

Constantine Farmakidis reports personal fees from MNOW.

Seniha Inan and Mark Milstein each declare no potential conflicts of interest.

Steven Herskovitz reports personal fees from Oxford University Press.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Saul R. Korey Department of Neurology, Montefiore Medical Center, Bronx, NY, USA

    Constantine Farmakidis, Seniha Inan, Mark Milstein & Steven Herskovitz

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  1. Constantine Farmakidis
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  2. Seniha Inan
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Correspondence to Constantine Farmakidis.

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This article is part of the Topical Collection on Secondary Headache

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Farmakidis, C., Inan, S., Milstein, M. et al. Headache and Pain in Guillain-Barré Syndrome. Curr Pain Headache Rep 19, 40 (2015). https://doi.org/10.1007/s11916-015-0508-x

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