From:  Pain management in Guillain-Barré Syndrome: a literature review

 Summary of interventions to manage pain in patients with GBS.

Author(s)GBS subtypeTreatment typeAgents/ApproachEffectiveness/Notes
Peña et al./2015 [11]Not specifiedNeuropathic agentsCarbamazepineReduced pain and need for rescue opioids like fentanyl/pethidine
Pandey et al./2005 [15]Not specifiedNeuropathic agentsGabapentin, carbamazepineGabapentin is more effective than carbamazepine, reduces fentanyl use significantly
Pandey et al./2002 [16]Not specifiedNeuropathic agents, opioidsGabapentin, fentanylLess fentanyl consumption during gabapentin periods than during placebo periods
Khatri & Pearlstein/1997 [14]Not specifiedNeuropathic agentsGabapentin (100 mg TID; 300 mg BID)Effective pain relief, well-tolerated; recommended in GBS pain management
Ritter et al./2023 [13]MFS secondary to SARS-CoV-2 infectionAntidepressants, neuropathic agentsAmitriptyline, pregabalin, gabapentinGabapentinoids were ineffective; pain resolved with amitriptyline, relapse of pain on taper
Liu et al./2015 [3]Not specifiedNeuropathic agentsGabapentin, carbamazepineBoth were effective vs. placebo, but no definitive recommendation due to study limitations
Tripathi & Kaushik/2000 [17]Not specifiedNeuropathic agentsCarbamazepineLower pain scores and reduced opioid (pethidine) needs; carbamazepine is recommended for ICU patients
McDouall & Tasker/2004 [18]Not specifiedNeuropathic agents vs. opioidsCarbamazepineArgued that carbamazepine is as effective for neuropathic pain as opioids, with fewer side effects (sedation, ventilation delay)
Ali & Hutfluss/1992 [19]Not specifiedEpidural analgesiaEpidural bupivacaine + fentanylSignificant visual analog scale reduction (9 → 2) and improved mobility
Morgenlander et al./1990 [20]Not specifiedTopical neuropathic agentCapsaicin 0.075% q6hProvided relief after failure of multiple agents; recurrence of pain on discontinuation
Koga et al./2000 [21]MFSNSAIDs, neuropathicNSAIDs, carbamazepineNeither class was effective for pain relief in their cohort
Connelly et al./1990 [22]Not specifiedEpidural opioidsFentanyl (epidural), then morphineEpidural opioids are effective where IV opioids and other agents have failed
Genis et al./1989 [23]Not specifiedEpidural opioidsEpidural morphine (1–4 mg q8–24h)8/9 patients responded positively: they were pain-free during the day and slept at night
Johnson & Dunn/2008 [24]Not specifiedOpioidsRemifentanil infusionEffective for 14 days with no significant tolerance
Ruts et al./2007 [25]Radicular pain, GBS subtype not specifiedCorticosteroidsMethylprednisolone + IVIgMixed results; radicular pain improved in most patients. A small sample size limits the ability to draw a definitive conclusion
van Doorn et al./2013 [26]Not specifiedCorticosteroidsHigh-dose steroidsEAN-PNS weakly recommends against high-dose corticosteroids
Hodgeman et al./2021 [28]Not specifiedIVIg + plasmapheresis142 g IVIg over 4 daysGradual pain reduction; successful outcome
Ding et al./2018 [29]Suspected GBS subtypesIVIgIVIg 0.4 mg/kg/day × 5 daysSignificant pain improvement and symptom resolution in both cases
Nixon/1978 [30]Not specifiedMiscellaneousQuinine sulfate ± aminophyllineNocturnal cramping pain relief lasting 8–12 h
Kiper et al./2025 [31]Not specifiedNon-pharmacotherapy: physical therapyStrength, ROM, functional training, aerobicImproved function, fatigue, strength, and well-being
Al-Zamil et al./2024 [32]Post-COVID GBS + ATMNon-pharmacotherapyTENSPain improvement; enhanced mobility and nerve function
Sendhilkumar et al./2013 [33]Not specifiedNon-pharmacotherapy: yoga, meditationPranayama yoga, meditation + rehabTrend toward pain improvement; not statistically significant
Titus et al./2024 [34]Sensory GBSMultimodalHydromorphone, lorazepam, gabapentinRefractory pain required escalation; emphasized individualized approaches
Return to article view

MFS: Miller-Fischer Syndrome; GBS: Guillain-Barré Syndrome; ATM: acute transverse myelitis; NSAIDs: non-steroidal anti-inflammatory drugs; IVIg: intravenous immunoglobulin; TID: three times a day; BID: twice a day; TENS: transcutaneous electrical nerve stimulation; EAN-PNS: European Academy of Neurology and the Peripheral Nerve Society.