Neuromodulation in Postherpetic Neuralgia: Case Reports and Review of the Literature

Kurklinsky, Svetlana; Palmer, Scott C.; Arroliga, Mack; Ghazi, Salim M.

doi:10.1093/pm/pnx175

Cited by 33 publications

(27 citation statements)

References 35 publications

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“…The novel placement of the lead near the maxillary nerve could be one factor as to the excellent pain relief achieved in the areas of upper teeth for the second patient of this report. Long-term SCS or PNS have been used to treat refractory PHN (38), and most authors have adopted permanent implantation methods. However, are these invasive procedures necessary to treat early PHN in elderly patients?…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

Zhao

Song

2021

Front. Neurol.

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Objective: We aimed to report on the use of short-term high cervical spinal cord stimulation (SCS) combined with peripheral nerve stimulation (PNS) to successfully treat trigeminal postherpetic neuralgia (TPHN) affecting the V2 and V3 divisions. We also sought to use a novel PNS approach to the maxillary nerve next to the external opening of the foramen rotundum (FR) to treat TPHN at the V2 division.Method: Two elderly patients successfully treated with different neuromodulation methods for TPHN are presented in this case series.Results: The first case referred to an 83-year-old Chinese female patient with V2 and V3 TPHN who experienced a significant pain relief using a combination of short-term high cervical SCS at the C1–C2 level and PNS on the infraorbital nerve (ION). Case 2 was a 68-year-old Chinese male patient with V1 and V2 TPHN that obtained an excellent pain relief after having received short-term PNS on the supraorbital nerve (SON), the supratrochlear nerve (STN), and the maxillary nerve. Both reported improvements in their quality of life and ability to perform daily tasks during a 3-month follow-up period.Conclusions: Short-term high cervical SCS at the C1–C2 spinal segments may be a feasible method to treat recent-onset V3 TPHN in elderly patients. Additionally, by placing the stimulation lead next to the external FR opening, we demonstrated a novel PNS approach to the maxillary nerve not previously reported for TPHN therapy.

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Section: Discussionmentioning

confidence: 99%

“…Long-term SCS or PNS have been used to treat refractory PHN ( 38 ), and most authors have adopted permanent implantation methods. However, are these invasive procedures necessary to treat early PHN in elderly patients?…”

Section: Discussionmentioning

confidence: 99%

Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

Zhao

Song

2021

Front. Neurol.

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“…Per the data, there was a 79% reduction in the mean numerical pain score from before to after implantation of the spinal cord stimulator. In studies evaluating patients undergoing a temporary trial with low-frequency SCS prior to permanent implantation, 42 out of 54 patients received long-term relief (10). One study noted a dramatic decrease of opioid use in 94.7% of patients (11).…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Successful High-Frequency 10-kHz Spinal Cord Stimulator Trial in a Patient with Refractory Thoracic Postherpetic Neuralgia

Alla¹

2021

PMCR

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Background: Spinal cord stimulation can be an effective treatment modality in patients suffering from postherpetic neuralgia who have failed first-line pharmacotherapy and continue to struggle from debilitating pain. Appropriate patient selection and having a wide array of stimulation waveforms can enhance the success of spinal cord stimulator trials. Case Report: In this article, we present a case report of a patient suffering from refractory thoracic postherpetic neuralgia who underwent a successful high-frequency 10-kHz spinal cord stimulator trial. Lead tips were successfully placed at the midline and left paramedial side of the top of T1 vertebral bodies at the source of the pain. The patient was followed up in our clinic 7 days post procedure. At the time of follow-up, our patient reported an 85% to 90% reduction in his pain symptom scores and a significant improvement in his quality of life. Conclusion: Similar successful trials for postherpetic neuralgia have been reported in small studies using traditional low-frequency stimulation waveforms. However, to our knowledge, this is the first report of a successful spinal cord stimulator trial using high-density 10 kHz. Key words: Postherpetic neuralgia, high-frequency spinal cord stimulator, acute herpes zoster

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“…In a case of postthoracotomy syndrome recalcitrant to medication management, treatment with SCS resulted in resolution of pain and allodynia (11). A review of treatment of postherpetic neuralgia with SCS reported 77.8% long-term pain relief in temporary SCS versus 47.1% in permanent SCS this is thought to be due to delayed placement of the permanent SCS leading to development of central sensitization (12). Analogously, failure of SCS in treatment for phantom limb pain is thought to be due to utilization of neuromodulation as a last resort in severe cases (13).…”

Section: Discussionmentioning

confidence: 99%

Treatment of Pain Due to Winged Scapula with Spinal Cord Stimulation: A Case Report

2021

PMCR

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BACKGROUND: Winged scapula (WS) is a protrusion of the scapula giving the appearance of a wing and can be due to either a musculoskeletal or neurological insult. Pain associated with WS is multifactorial, including myofascial and neuronal mechanisms, and may be difficult to treat. CASE REPORT: In a case of WS refractory to conservative management with physical therapy and medications and not a candidate for nerve repair, we treated the pain with a spinal cord stimulator. We report significant pain reduction and improvement in function with the procedure. CONCLUSION: This case suggests a role for neuromodulation in WS and requires further investigation. KEY WORDS: Winged scapula, spinal accessory nerve injury, spinal cord stimulation, neuromodulation

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Neuromodulation in Postherpetic Neuralgia: Case Reports and Review of the Literature

Abstract: Based on our review of the literature and the two cases at MCF, subcutaneous PNS seems to be a promising intervention in the treatment of PHN.

Cited by 33 publications

References 35 publications

Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

A Case Report of Successful High-Frequency 10-kHz Spinal Cord Stimulator Trial in a Patient with Refractory Thoracic Postherpetic Neuralgia

Treatment of Pain Due to Winged Scapula with Spinal Cord Stimulation: A Case Report

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