Abstract
Chronic central pain is a frequent complication after spinal cord injury. Anticonvulsant drugs, among them valproate, have been recommended for treatment. In this paper we conducted a double-blind, cross-over study comparing valproate and placebo for severe chronic central pain. During the study, serum concentration of valproate, pain and side effects were registered and the dose was adjusted according to these. No significant analgesic effects of valproate could be demonstrated although serum concentration and dose reached a high level. Few studies of pain following spinal cord injury exist and we recommend that further studies be performed.
Similar content being viewed by others
Article PDF
References
Munro D (1948) Rehabilitation of veterans paralysed as the result of injury of the spinal cord and cauda-equina injuries. Am J Surg 75: 3–17.
Burke D C (1973) Pain in paraplegia. Paraplegia 10: 297–313.
Davis L, Martin J (1947) Studies upon spinal cord injuries II. The nature and treatment of pain. J Neurosurg 4: 483–491.
Botterell E H, Callahan J C, Jousse A T (1954) Pain in paraplegia. Clinical management and surgical treatment. Proc R Soc Med 47: 281–288.
Drewes A M, Andreasen A, Olsson A T, Slot O (1989) Sygdomsforløbet hos patienter indlagt i en rehabiliteringsafdeling efter rygmarvslaesion. Ugeskrift for lger 151: 3233–3236. (Summary in English).
Melzack R, Loeser J D (1978) Phantom body pain in paraplegics: Evidence for a central ‘pattern generating mechanism’ for pain. Pain 4: 195–210.
Davis R (1975) Pain and suffering following spinal cord injury. Clin Orthop 112: 76–80.
Drewes A M, Helweg-Larsen S, Petersen P et al 1993 McGill Pain Questionnaire translated into Danish: Experimental and clinical findings. Clin J Pain 9: 80–87.
Deschamps M, Band P R, Coldman A J (1988) Assessment of adult cancer pain. Pain 32: 133–139.
Woolsey R M (1986) Chronic pain following spinal cord injury. J Am Paraplegia Soc 9: 39–41.
Hills M, Armitage P (1979) The two-period cross-over clinical trial. J Clin Pharmacol 8: 7–20.
Pagni C A (1984) Central pain due to spinal cord and brain stem damage. In: Wall PD, Melzack R, editors. Textbook of Pain. Churchill Livingston, New York: 481–495.
Lenz F A, Tasker R R, Dostrovsky J O et al (1987) Abnormal single-unit activity recorded in the somatosensory thalamus of a quadriplegic patient with central pain. Pain 31: 225–236.
Gram L (1988) Experimental studies and controlled clinical testing of valproate and vigabatrin. Acta Neurol Scand 78: 241–270.
Auff E, Holzner F, Wessely P (1985) Weitere Therapie-möglichkeiten mit Valproinsäure (Convulex). Wiener Medizinischer Wochenschrift 135: 421–423. (Summary in English).
Sørensen K V (1988) Valproate: A new drug in migraine prophylaxis. Acta Neurol Scand 78: 346–348.
Balazy T E (1992) Clinical management of chronic pain in spinal cord injury. Clin J Pain 8: 102–110.
Frisbie J H, Aguilera E J (1990) Chronic pain after spinal cord injury: An expedient diagnostic approach. Paraplegia 28: 460–465.
Donovan W H, Dimitrijevic M R, Dahm L et al 1982 Neurophysiological approaches to chronic pain following spinal cord injury. Paraplegia 20: 135–146.
Maury M (1978) About pain and its treatment in paraplegics. Paraplegia 15: 349–352.
Hachen H J (1978) Psychological, neurophysiological and therapeutic aspects of chronic pain: Preliminary results with transcutaneous electrical stimulation. Paraplegia 15: 353–367.
Sandford P R, Lindblom L B, Haddox J D (1992) Amitriptyline and carbamazepine in the treatment of dysesthetic pain in spinal cord injury. Arch Phys Med Rehabil 73: 300–301.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Drewes, A., Andreasen, A. & Poulsen, L. Valproate for treatment of chronic central pain after spinal cord injury. A double-blind cross-over study. Spinal Cord 32, 565–569 (1994). https://doi.org/10.1038/sc.1994.89
Issue Date:
DOI: https://doi.org/10.1038/sc.1994.89
Keywords
This article is cited by
-
Pharmacologic therapies of pain in patients with spinal cord injury: a systematic review
Spinal Cord Series and Cases (2022)
-
Efficacy and safety of different drug treatments in patients with spinal-cord injury-related neuropathic pain: a network meta-analysis
Spinal Cord (2022)
-
Central Neuropathic Pain Syndromes: Current and Emerging Pharmacological Strategies
CNS Drugs (2022)
-
Ravages of Diabetes on Gastrointestinal Sensory-Motor Function: Implications for Pathophysiology and Treatment
Current Gastroenterology Reports (2016)
-
Management of Neuropathic Pain Associated with Spinal Cord Injury
Pain and Therapy (2015)