Gabapentina no tratamento da dor decorrente de cistos perineurais sacrais: relato de caso
Gabapentin to treat sacral perineural cyst-induced pain: case report
Elza Magalhães; Ana Márcia Mascarenhas; Durval Campos Kraychete; Rioko Kimiko Sakata
Resumo
Palavras-chave
Abstract
BACKGROUND AND OBJECTIVES: Perineural cysts may induce difficult to control neuropathic pain. Anticonvulsivants are used to treat such pain. This report aimed at presenting a case of total pain remission with gabapentin after failure of all other therapeutic alternatives used.
CASE REPORT: Female, diabetic patient, 67 years old, complaining of lumbosacral pain for two months, with the following characteristics: daily, sharp and burning pain of mild to moderate intensity irradiating to posterior thigh. Pain would worsen with movement and in the standing position. Six months before she had had a similar pain episode which improved with steroids. Lumbosacral spine MRI showed 2.5 cm sacral perineural cyst injuries at S1, S2 and S3, compressing the dural sac and associated to bone erosion. Gabapentin was introduced in progressive doses until 900 mg/day, with complete pain relief.
CONCLUSIONS: Tarlov's cyst neuropathic pain may be adequately controlled with gabapentin.
Keywords
Referências
Yucesoy K, Naderi S, Ozer H. Surgical treatment of sacral perineural cysts: A case report. Kobe J Med Sci. 1999;45:245-250.
Voyadzis J, Bhangava P, Handerson FC. Tarlov cysts: a study of 10 cases with review of the literature. J Neurosurg. 2002;95:25-32.
Kim CH, Bak KH, Kim JM. Symptomatic sacral extradural arachnoid cysts associated with lumbar intradural arachnoid cyst. Clin Neurol Neurosurg. 1999;101:148-152.
Amoiridis G, Wohrle J, Przuntec H. Lumbosacral perineural cysts as cause for neurogenic muscular hypertrophy. Eletromyogr Clin Neurophysiol. 1997;37:273-275.
Rabb CH, McComb JG, Raffel C. Spinal arachnoid cysts in the pediatric age group: on association with neural defects. J Neurol. 1992;77:369-372.
Nedler SF, Bartoli LM, Stitik TP. Tarlov cyst as a rare cause of S1 radiculopathy: a case report. Arch Phys Med Rehabil. 2001;82:689-690.
Myles LM, Gupta N, Armstrong D. Multiple extradural arachnoid cysts as a cause of spinal cord compression in a child. J Neurosurg. 1999;91:116-120.
Nomo Y, Nanjo Y, Nagashima H. Sacral cysts managed with cysts - subarachnoid shunt. Spine. 2001;4:451-453.
Nicholson B. Gabapentin use in neuropathic syndromes. Acta Neurol Scand. 2000;101:359-371.
Mummaneni PV, Pitts LH, McCormack BM. Microsurgical treatment of symptomatic sacral Tarlov cysts. Neurosurgery. 2000;47:74-79.
MacPherson RD. The pharmacological basis of contemporary pain. Pharmacol. 2000;88:163-165.
Hays H, Woodroffe MA. Using gabapentin to treat neuropathic pain. Can Fam Physician. 1999;45:2109-2112.
Hernanez JL. Dados actuales sobre la gabapentina. Rev Neurol. 2000;301:125-131.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email