Page 64 - GALENIKA MEDICAL JOURNAL

pratiti bolesnike duži vremenski period i obuhvatiti veći broj ispitanika, kako bi se definisali korelati
i adekvatni terapijski modaliteti. Svakako je preporuka da se u narednim ispitivanjima bolesnici
sa istim tipom bola, podjele u jasno definisane grupe, kako bi se adekvatno procijenio terapijski
uspjeh određenog preparata u kupiranju bola. Za ljekare kliničare je najvažnije da bi trebalo misliti
o bolu kao simptomu kod bolesnika sa GBS koji bi trebalo adekvatno tretirati, kako bi se poboljšao
kvalitet života oboljelih. Zato je preporučljivo koristiti specifične upitnike za prepoznavanje kvaliteta
i kvantiteta bola u svakodnevnoj kliničkoj praksi, kako pri dijagnostikovanju, tako i prilikom
dugotrajnog praćenja bolesnika sa GBS.

Abstract

Immune-mediated neuropathies, including Guillain-Barré Syndrome (GBS), represent a heterogeneous group of disorders
caused by a loss of immune tolerance to antigens of peripheral nerves or surrounding blood vessels. Clinically, GBS is
characterized by the development of symmetrical muscle weakness over up to four weeks, accompanied by sensory
disturbances and dysautonomia. Pain is a common symptom of GBS, but unfortunately, it is often overlooked. Pain should
be viewed multidimensionally, and the biopsychosocial model is currently widely accepted. Pain assessment is conducted
using various unidimensional, multidimensional, and specialized scales to detect the neuropathic component of pain.
Regarding pain as the first symptom of the disease, previous studies have shown that this is the case in about 70% of
patients. Pain in GBS patients has both neuropathic and nociceptive components. A previous study conducted on GBS
patients in our population found that the prevalence of pain in the acute phase was 85.5%, and neuropathic pain was
present in 26.4% of cases. Rare studies have shown that after the acute phase of the disease, pain decreases, but sensitive
neuropathic elements such as paresthesias/dysesthesias often remain. It is also assumed that pain plays a significant
role in worsening depression and anxiety, as well as negatively impacting the quality of life and sleep in GBS patients.
Pain management in GBS involves both specific (Intravenous Immunoglobulin Therapy, IVIG, and/or Therapeutic Plasma
Exchanges, TPE) and nonspecific treatment methods (supportive therapy), as well as the use of analgesics and co-analgesics
based on the principles of treating pain syndromes, depending on the assumed pathophysiological mechanism. After the
acute phase of the disease, special attention is given to physical rehabilitation treatment and psychosocial support for the
patient. Therefore, the involvement of other specialists (physiatrist, psychiatrist, clinical psychologist, and pain medicine
specialist) is of crucial importance for adequate pain management.

Keywords: neuropathy, Guillian-Barre syndrome, pain, quality of life

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62 DOI: 10.5937/Galmed2411053S