Neuropathic Pain and Methylprednisolone

[Wise Young]

I was wondering how many people who have neuropathic pain here received methylprednisolone. wise.

[betheny]

I got the mp @ like 7 hrs, 45 min. It's the oddest thing, had been reading a reader's digest during a downtime @ work the week before that talked about it. So I told the ER dr. who was busy, he knew but it took him that long to get it to me. I did have a lot of funxnl return.

[LaMemChose]

Is the methylprednisolone the same as dexamethasone? I was given dexamethasone.

I have neuro pain.

[rybread]

I was wondering how many people who have neuropathic pain here received methylprednisolone. wise.
Are you thinkinking theres a link? what about all those people who had neuropain before methylprednisolone? shouldn't that disprove link?

[Wise Young]

Is the methylprednisolone the same as dexamethasone? I was given dexamethasone.

I have neuro pain.

LaMemChose,

Dexamethasone is a glucocorticoid. It is more potent (about 5x more) than methylprednisolone. We chose methylprednisolone and used a very high dose (30 mg/kg bolus followed by 5.4 mg/kg/hour for 24 or 48 hours) because this was the dose that we found was most effective. The reason for such high doses was because we thought that the drug should be acting both as a glucocorticoid and as an antioxidant. The equivalent corticosteroid dose should therefore be 6 mg/kg bolus followed by about 1 mg/kg/hour for 24-48 hours but it would not have the same antioxidant effect.

Wise.

[Wise Young]

Are you thinkinking theres a link? what about all those people who had neuropain before methylprednisolone? shouldn't that disprove link?

rybread,

The hypothesis is that methylprednisolone reduces the incidence and severity of neuropathic pain. If the hypothesis is true, there should be more neuropathic pain in the past and less since high-dose methylprednisolone started in 1990. Because people with gunshot wounds are not usually treated with methylprednisolone, they should continue to have a high incidence.

Wise.

[cali]

i had methylprednisolone very quickly after my accident, about 15-30 minutes after. guess i was lucky to have it happen right by the emt station. i get nerve pain, somedays it's hard to ignore and hurts a ot.

[rfbdorf]

I haven't voted because I'm not sure where my wife's experience fits in.
She had pain before the operation that resulted in paraplegia (in 2005) and it continued after it, but it has always been confined to her back. Perhaps it is not neuropathic? When I asked about methylprednisolone, her neurosurgeon dismissed it as "experimental." And we had thought he was the hot-shot in the area.
- Richard

[adi chicago]

yes i had mp 18 hrs after my injury.

[SoFla]

I have not voted yet. I have a few questions. My records show that I recieved 125MG. Should I assume that Barth Green did that as routine during the surgery to remove intramedullary tumor? Is 125MG considered high dose?

[alan]

I didn't get MP - injured in 1981.

[bcsimpsons]

Just a comment to my vote. I have neuro pain, injured in 2004. Did not receive mp.

I guess that was more of a statement, lol.

Becky,
chicago

[adi chicago]

Just a comment to my vote. I have neuro pain, injured in 2004. Did not receive mp.

I guess that was more of a statement, lol.

Becky,
chicago
jeez...which hospital in chicago becky?

[Sue Pendleton]

I don't feel I don't fit well in the 4 choices, Wise. I had a spinal infarct and while there was no concrete diagnosis until about 3 days afterwards I was given the high dose methylprednisolone (Solumedrol). I believe I got the bolus about 9 or 10 hours after initial pain then the 5mg for three days. I was taken off it for about 24 hours for a spike in fever (later traced to the central line); treated with vancomycin; and then, back on a higher dose (then described in the protocol for traumatic acute SCI) for a longer tapering period than was normally used. I was treated at the C(Z)entral Klinikum in Augsburg, Germany back in 1992. Since I had a CT of my brain including the stem while still conscious and it was negative for everything I was treated as if I had TM once unconscious, intubated and on a bunch of other tubes keeping me going. A portable Xray ruled out any vertabral/spinal damage at the C level. I believe the lumbar puncture ruled out TM and several weirder things it could have been.

I had neuro pain develop in my right arm as that hand contracted. That pain slowly disappeared after a few months then the thighs got the serious, serious burn. My quads came back to 5s though in strength after 3 or 4 years. I still get bouts of neuro pain but what seems to be the only constant is my feet. Oh, and add arthritis pain in the contracted hand and my toes. Does serious shoulder pain from all those antibiotics and torn tendons in the area count?

Oh, and speaking to many neurologists they believe the window is wider for those with TM and those who have a catastrophic first hit of MS.

[Wise Young]

I don't feel I don't fit well in the 4 choices, Wise. I had a spinal infarct and while there was no concrete diagnosis until about 3 days afterwards I was given the high dose methylprednisolone (Solumedrol). I believe I got the bolus about 9 or 10 hours after initial pain then the 5mg for three days. I was taken off it for about 24 hours for a spike in fever (later traced to the central line); treated with vancomycin; and then, back on a higher dose (then described in the protocol for traumatic acute SCI) for a longer tapering period than was normally used. I was treated at the C(Z)entral Klinikum in Augsburg, Germany back in 1992. Since I had a CT of my brain including the stem while still conscious and it was negative for everything I was treated as if I had TM once unconscious, intubated and on a bunch of other tubes keeping me going. A portable Xray ruled out any vertabral/spinal damage at the C level. I believe the lumbar puncture ruled out TM and several weirder things it could have been.

I had neuro pain develop in my right arm as that hand contracted. That pain slowly disappeared after a few months then the thighs got the serious, serious burn. My quads came back to 5s though in strength after 3 or 4 years. I still get bouts of neuro pain but what seems to be the only constant is my feet. Oh, and add arthritis pain in the contracted hand and my toes. Does serious shoulder pain from all those antibiotics and torn tendons in the area count?

Oh, and speaking to many neurologists they believe the window is wider for those with TM and those who have a catastrophic first hit of MS.


Sue,

Sorry, I should have put in a category of people who had gotten methylprednisolone and did not fit into any of the categories, as well as a category for people who took dexamethasone (which should have the same effect on sprouting as methylprednisolone).

Wise.

[alan]

They gave me some kind of steroid at Shockarama in '81 (it caused a rash - I remember the nurses telling me about it.)

[Sue Pendleton]

They gave me some kind of steroid at Shockarama in '81 (it caused a rash - I remember the nurses telling me about it.)

Was it IV, oral, sub q or an inhaler type thing, Alan? I know Shock Trauma used Tiriliziad as part of its trials later for methylprednisolone as a comparison. So maybe it was that. Otherwise my guess is you got something to keep pnuemonia away and bronchial tubes open.

[SoFla]

Dr Young, please read post #10. I think my questions were overlooked. Thanks!

[addiesue]

I had it in the helicopter and I have nerve pain in feet and calves. Some days untolerable, but most I can deal with it.

[Wise Young]

I have not voted yet. I have a few questions. My records show that I recieved 125MG. Should I assume that Barth Green did that as routine during the surgery to remove intramedullary tumor? Is 125MG considered high dose?

Sofla, I am sorry that I didn't see your post. A 125 mg per day dose is the standard dose of MP and not the high-dose. In acute spinal cord injury, the dose that we discovered to be useful is 30 mg/kg bolus followed by 5.4 mg/kg/hour. If you are 50 kg (110 lb), you would be gettig a 1500 mg bolus followed by 6500 mg over 24 hours. This adds up to about 8 grams of drug and that is for a small person. A typical 65 kg person will get about 10 grams during the first 24 hours after injury.

Wise.

[knowthill]

I never have taken methylprednisolone.

[SoFla]

Sofla, I am sorry that I didn't see your post. A 125 mg per day dose is the standard dose of MP and not the high-dose. In acute spinal cord injury, the dose that we discovered to be useful is 30 mg/kg bolus followed by 5.4 mg/kg/hour. If you are 50 kg (110 lb), you would be gettig a 1500 mg bolus followed by 6500 mg over 24 hours. This adds up to about 8 grams of drug and that is for a small person. A typical 65 kg person will get about 10 grams during the first 24 hours after injury.

Wise.
Thanks for the explaination. I suppose I didn't get more because there was every expectation that I would walk out of the hospital. I do not know in which catagory I fit for voting, so I will simply say that I have neuropathic pain.

[Art454]

Since I got hurt in 1975 I have no idea what I was given as they operated 2 hours after I got hurt. Any idea's what if anything I was given Wise?
I was sent to U of Michigan and I no I wasn't given anything till I went into surgery. The dark ages probably nothing back then.....lol

[Fragile]

I was given it within an hour. Central nerve pain started about 10 years later.

[Skye83]

Wise:My intramedullary T8-10 tumor (ependymoma) was discovered in Nov 1997, wholly occupying the spinal cord at that level, as well as C7-T11 syrinx. I had no pain of any kind. I was started on oral dexamethasone right away, but I can't remember the dosage.

The surgery was December 18, 1997 and at that time, the methylprednisolone spinal cord protocol was instituted with a 30 mg/kg loading dose and a 5.4 mg/kg/hour continuous infusion of the drug.

I have ungodly central pain from the waist down that began about 4 months post-surgery and continues to worsen. But at least I am ambulatory.

[mountainman]

Hi I Didn't Vote Because My Injuries Are Self Inflicted From Working Like A Mule, But I Do Have A Syrinx On My Cord At C-2 Thru C-6 . I Have Had Methylprednisolone In My Shots At The Pain Clinic And They Helped In The Pain In My Legs And Feet. The Strange Part About It Is I Had Got Ivy Poison Some Time Later And My Doc Gave Me A Packet Of Methylprednisolone To Cure It Up And It Helped With My Leg And Back Pain. The Next Time I Went To The Pain Clinic I Told My Pain Doc That Taking The Drug Oraley Helped With My Pain But He Said You Can't Stay On It For Pain Management.

[Skye83]

Wise:My intramedullary T8-10 tumor (ependymoma) was discovered in Nov 1997, wholly occupying the spinal cord at that level, as well as C7-T11 syrinx. I had no pain of any kind. I was started on oral dexamethasone right away, but I can't remember the dosage.

The surgery was December 18, 1997 and at that time, the methylprednisolone spinal cord protocol was instituted with a 30 mg/kg loading dose and a 5.4 mg/kg/hour continuous infusion of the drug.

I have ungodly central pain from the waist down that began about 4 months post-surgery and continues to worsen. But at least I am ambulatory.

Well, they say chronic pain shrinks the brain. :o My tumor was very slow growing and even though it was within the central canal of a very swollen cord, I had very little in the way of symptoms-hyperreflexia at the knees and occasionally a numb right big toe when I walked. That goes to show how accommodating (adapting) the human body can be.

So, I don't qualify for this poll, tho I'm sure the methylprednisolone administered during surgery must have helped while my cord was being filleted.....