Epidural Morphine Treatment of Pain in Guillain-Barre Syndrome

The discovery of specific opiate receptors in the spinal cord and brain formed the anatomic rationale for the subsequent use of both epidural and intrathecal narcotics to control pain.1The efficacy of spinally administered narcotics in treating postoperative and chronic pain conditions is widely accepted.2The pain in these chronic disorders is usually caused by tissue compression, or neural invasion from either primary or metastatic neoplasms. There are no reports in the literature about the efficacy of spinally administered narcotics in the treatment of the pain associated with inflammatory peripheral neuropathies. We describe a patient with Guillain-Barré syndrome who had severe dysesthetic pain unresponsive to routine analgesics and other therapeutic maneuvers, who was successfully managed with epidural morphine sulfate. REPORT OF A CASE A 20-year-old man with no known previous medical problems, presented with three days of increasing weakness of his extremities associated with paresthesias. He was