Successful treatment of tabetic lightning pain and visceral crisis with gabapentin

摘要

Lightning limb pain, a clinical feature of tabes dorsalis, is extremely severe and is refractory to various therapeutic approaches [1]. We report the case of a 61-year-old man who had severe paroxysmal lower limb pain for a decade because of tabes dorsalis. Nine years ago, he was diagnosed with tabes dorsalis and treated with high-dosage penicillin. The pain attacks were managed with carbam-azepine. At the time of presentation, the patient complained of severe paroxysmal pain that was characterized by a pulling sensation extending from both legs up to the buttocks and which occurred three or four times daily. He writhed in pain, but apart from his pain attacks, he had no other complaints.