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Keywords:

  • dysautonomia;
  • Guillain–Barré syndrome;
  • painful dysesthesia;
  • pregabalin

Abstract

Guillain–Barré syndrome (GBS) is frequently accompanied by dysautonomia, which potentially leads to a fatal outcome. Pregabalin binds to the α2δ subunit of voltage-gated calcium channels and has been used as a drug for neuropathic pain. We present a 47-year-old woman who had GBS with severe dysautonomia and painful dysesthesia, in whom pregabalin promptly attenuated both symptoms. After symptoms of respiratory infection lasting a week, she showed mydriatic pupils, ophthalmoparesis, weakness in four limbs with areflexia, cerebellar ataxia and limb dysesthesia. Even after intravenous immunoglobulin therapy was started, her neurological symptoms deteriorated; furthermore, she developed severe dysautonomia including intractable hypertension, bradycardia–tachycardia syndrome, paroxysmal facial flushing and paroxysmal nausea. However, promptly after the first dose of pregabalin, both dysautonomia and dysesthesia were attenuated, and her circulatory condition became stable. Thereafter, her neurological symptoms gradually improved. The present case report suggests that pregabalin can be effective in treating dysautonomia, as well as painful dysesthesia in GBS.