Spinal Cord Stimulation for Treatment of Neuropathic Pain Associated With Erythromelalgia

Abstract

Spinal cord stimulation may be a promising treatment of neuropathic pain associated with erythromelalgia.

Current pain management strategies for patients with erythromelalgia: a critical review

“…There are three case reports of spinal cord stimulator implantation for refractory pain 81–83. This was conducted in patients with refractory pain and was considered after successful trial by placing percutaneous spinal cord stimulator electrodes in the epidural space.…”

Dorsal Root Ganglion Stimulation for Erythromelalgia Related Foot Pain: A Case Report and Review of the Literature

“…Two years after implantation, she continued to do well, was back in school, and able to wear footwear. 5 Matzke et al 6 described the case of an 80-year-old woman with bilateral distal lower extremity burning pain for greater than 15 years, diagnosed as secondary erythromelalgia from diabetes mellitus type II. She found short-term pain relief with cooling of the feet, but had tried and failed many other conservative options without relief.…”

“…She did well immediately afterward, and at 18 months follow-up continued to report a tolerable 4 of 10 average pain with supplemental pain medications up to 2 times per month. 6 Most recently, Eckman et al 7 described a 20-yearold man with generalized neuropathic features, including numbness, tingling, and pain of the upper and lower extremities and face, which was attributed to a diagnosis of primary erythromelalgia. The patient had failed conservative measures and underwent a successful tonic, paresthesia-based SCS trial with one lead at the top of C3 and another at the top of T8.…”

“…3 Spinal cord stimulation (SCS) for the treatment of erythromelalgia-related pain has been previously reported in the literature, whereas DRG stimulation remains to be described. [4][5][6][7] Given the clinical research showing superior pain control with DRG stimulation for chronic neuropathic pain in the distal lower extremities, and the known pathological DRG changes associated with primary erythromelalgia, we hypothesized that DRG stimulation would be beneficial for primary erythromelalgiarelated pain in the distal lower extremities. Herein, we present a case of primary erythromelalgia-related pain at the bilateral plantar surfaces of the feet, which was treated successfully with bilateral sacral S1 nerve root DRG stimulation.…”

Case Report and Literature Review: Interventional Management of Erythromelalgia

“…For neuropathic pain, spinal cord stimulators may relieve pain by modulating local neurotransmitter levels in the dorsal horns [19,20]. Similarly, targeting DRG neurons with stimulation has been reported as a treatment of erythromelalgia [16].…”