Patients with AFM are at high risk for pain/allodynia. In sedated patients or young children, pain may be recognized by irritability, tachycardia, and refusal to move or participate in therapy.
- Recognition of and treatment for pain/allodynia may allow for reduced exposure to sedating medications and improved cooperation with therapy/early mobilization. Anecdotally, gabapentin has been effective in reducing pain in AFM patients. Consider starting pain medications early and titrating to effect.
- Dysautonomia/dysrythmias can occur. Monitoring is recommended.
- Anxiety may accompany pain and exacerbate the pain symptoms. Low dose benzodiazepines may be a useful adjunct to pain medications in some patients.
- For patients with incomplete eye closure, order scheduled lacrilube to prevent corneal abrasions. Corneal abrasions are also a source of pain.
- Early mobilization/therapy may help minimize pain and secondary injuries associated with immobilization and weakness.