Peripheral Subcutaneous Neurostimulation in the Management of Neuropathic Pain: Five Case Reports

Reverberi, Claudio; Bonezzi, C.; Demartini, Laura

doi:10.1111/j.1525-1403.2009.00201.x

Cited by 41 publications

(42 citation statements)

References 14 publications

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“…In the 1970s, PNS was seldom performed because the high morbidity and poor long-term outcomes related to poor patient selection and technical limitations for inadequate devices. However, growing evidences suggested that PNS is effective, in particular NP syndromes characterized by peripheral nerve lesions or irritation with pain or positive phenomena with a localized peripheral nerve distribution [9, 21, 27, 31, 32]. …”

Section: Discussionmentioning

confidence: 99%

“…Peripheral nerve stimulation (PNS) has been used by a small group of neurosurgeons for the treatment of chronic peripheral neuropathic pain since 1967 [30]. Although in literature, PNS was demonstrated to be quite successful in the short and medium term [4, 6, 9, 21, 27, 29], PNS has never become a standard technique for treatment of NP syndromes. This may be due to technical difficulties with paddle-type electrodes inserted around the peripheral nerve and to the risk of infections or electrode dislocation.…”

Section: Introductionmentioning

confidence: 99%

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Chronic post-traumatic neuropathic pain of brachial plexus and upper limb: a new technique of peripheral nerve stimulation

et al. 2014

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The aim of the study was to evaluate the effect on pain relief in patients with peripheral neuropathic pain after brachial plexus injuries using an implanted peripheral nerve stimulator applied directly to the nerve branch involved into the axillary cavity. Seven patients with post-traumatic brachial plexus lesions or distal peripheral nerve complaining of severe intractable chronic pain were enrolled in a single-centre, open-label trial. Conventional drugs and traditional surgical treatment were not effective. Patients underwent careful neurological evaluation, pain questionnaires and quantitative sensory testing (QST). Surgical treatment consists of a new surgical technique: a quadripolar electrode lead was placed directly on the sensory peripheral branch of the main nerve involved, proximally to the site of lesion, into the axillary cavity. To assess the effect, we performed a complete neuroalgological evaluation and QST battery after 1 week and again after 1, 6 and 12 weeks. All patients at baseline experienced severe pain with severe positive phenomena in the median (5) and/or radial (2) territory. After turning on the neuro-stimulator system, all patients experienced pain relief within a few minutes (>75 % and >95 % in most), with long-lasting pain relief with a reduction in mean Numerical Rating Scale (NRS) of 76.2 % after 6 months and of 71.5 % after 12 months. No significant adverse events occurred. We recommend and encourage this surgical technique for safety reasons; complications such as dislocation of electrocatheters are avoided. The peripheral nerve stimulation is effective and in severe neuropathic pain after post-traumatic nerve injuries of the upper limbs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chronic post-traumatic neuropathic pain of brachial plexus and upper limb: a new technique of peripheral nerve stimulation

et al. 2014

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“…31 Increasing interest about PNS and PNFS in recent years has led to a wider use of neurostimulation to control headache and pain in the extremities and in the occipital region. 1,7,9,11,14,17,21,22,25,28 Manufacturing developments have made it possible to reduce the thickness of the electrodes, which can also be used in facial regions without any esthetic impairment. A clear differential diagnosis between TNP and PIFP versus classic trigeminal neuralgia is mandatory to assess the proper treatment plan.…”

Section: Discussionmentioning

confidence: 99%

Peripheral trigeminal nerve field stimulation

Feletti

Santi

Sammartino

et al. 2013

FOC

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Object Peripheral nerve field stimulation has been successfully used for many neuropathic syndromes. However, it has been reported as a treatment for trigeminal neuropathic pain or persistent idiopathic facial pain only in the recent years. Methods The authors present a review of the literature and their own series of 6 patients who were treated with peripheral nerve stimulation for facial neuropathic pain, reporting excellent pain relief and subsequent better social relations and quality of life. Results On average, pain scores in these patients decreased from 10 to 2.7 on the visual analog scale during a 17-month follow-up (range 0–32 months). The authors also observed the ability to decrease trigeminal pain with occipital nerve stimulation, clinically confirming the previously reported existence of a close anatomical connection between the trigeminal and occipital nerves (trigeminocervical nucleus). Conclusions Peripheral nerve field stimulation of the trigeminal and occipital nerves is a safe and effective treatment for trigeminal neuropathic pain and persistent idiopathic facial pain, when patients are strictly selected and electrodes are correctly placed under the hyperalgesia strip at the periphery of the allodynia region.

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“…geniş A-beta liflerinin daha küçük A-delta ve C fiberlerine afferent çıkışlarda dönüştüğünü tanım-lamışlardır. [25] Başka bir makalede de, [26] sinirden başlayıp ciltte sonlanan membran depolarizasyon ve antienflamatuvar temelindeki mekanizmayı öne sürmektedir, fakat o da A-beta sinir lifi aktivasyonunu tanımlamıştır. Bu mekanizmalar ancak daha çok yapılacak olan çalışmalarla açıklanabilecektir.…”

Section: Pain a Riunclassified

“…Spinal kord stimülasyonunun aksine SUBQ stimülasyonu etkilenen ağrı bölgesindeki kutanöz afferent ya da bu sinirlerin dermatomal dağılımlarının olduğu Alana yerleştirerek sağlanır. [6][7][8][9][10] Yapılan çalışmalar, kronik ağrı tedavisinde spinal kord stimülasyonu uygulamasının güvenli ve efektif olduğunu göstermiştir. [11,12] Bu yazıda lumbar disk hernisi nedeniyle operasyon geçiren ve sonrasında postlaminektomi sendromu gelişen ve SKS uygulanmasına rağmen sağ kalça ve bel bölgesinde ağrı şi-kayeti devam eden hastaya sağ kluneal sinir dağılım bölgesine oktad elektrod'un subkutan (SUBQ) olarak yerleştirildiği hastadan bahsedilmektedir.…”

Section: Introductionunclassified

Subcutaneous stimulation as additional therapy to spinal cord stimulation in a post-laminectomy syndrome patient

Akbaş

Yeğin

Özdemir

et al. 2016

Agri

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Peripheral Subcutaneous Neurostimulation in the Management of Neuropathic Pain: Five Case Reports

Cited by 41 publications

References 14 publications

Chronic post-traumatic neuropathic pain of brachial plexus and upper limb: a new technique of peripheral nerve stimulation

Chronic post-traumatic neuropathic pain of brachial plexus and upper limb: a new technique of peripheral nerve stimulation

Peripheral trigeminal nerve field stimulation

Subcutaneous stimulation as additional therapy to spinal cord stimulation in a post-laminectomy syndrome patient

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