• Medicine · Jun 2021

    Case Reports

    Intrathecal drug delivery to treat intractable neuropathic pain following Sjögren's syndrome-induced transverse myelitis: A case report.

    • Ji Yeong Kim, Yong Ho Lee, Ji Young Kim, Hyun Hwa Lee, and KimYoung HoonYH0000-0001-6685-1244Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea..
    • Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul.
    • Medicine (Baltimore). 2021 Jun 4; 100 (22): e26141e26141.

    RationaleTransverse myelitis (TM) is a spinal cord inflammatory myelopathy that causes motor/sensory loss and urinary retention below the level of the affected spinal cord. Although a few case reports have described the control of neuropathic pain in patients with TM via spinal cord stimulation, no documented case regarding the control of severe allodynia following TM via intrathecal pump has been described.Patient ConcernsA 37-year-old woman was referred to a pain clinic for severe intractable pain below the T5 level followed by Sjögren's syndrome-induced TM.DiagnosesA neurological examination revealed paresthesia and allodynia below the T5 level. The sensory evaluation was limited by extreme pain and jerking movements. The muscle strength of both lower limbs was grade 3.InterventionsIntrathecal pump was inserted into the left lower abdomen. Catheter tip was placed at the midline of the T8 level.OutcomesThe numeric rating scale (NRS) for pain score decreased from 10 to 5. Functional Independence Measure score increased from 67 before implantation to 92 at the time of discharge, while the patient's Barthel score increased from 31 to 46.LessonsNeuropathic pain due to Sjögren's syndrome-related TM could be controlled effectively using the intrathecal morphine pump.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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