Alaa A Abd-Elsayed
University of Wisconsin, USA
Posters & Accepted Abstracts: J Neurol Neurophysiol
Introduction: Peripheral neuropathy results from damage to the peripheral nervous system with symptoms ranging in severity from numbness, paresthesias, and allodynia to muscle weakness, paralysis, and organ dysfunction. Approximately 20-30% of cases reported emerge idiopathically without identifiable risk factors. Pain is usually resistant to conservative management. We present a unique case of idiopathic peripheral neuropathy alleviated with spinal cord stimulator placement. Case Description: A 71 year-old male with lumbar facet hypertrophy (as evidenced on MRI at L4-5, L5-S1), lumbago, and idiopathic peripheral neuropathy presented to pain clinic. Patient had normal physical exam including strength, sensation, reflexes, and gait with exception of positive bilateral straight leg raise at 90 degrees and tenderness to direct palpation over lumbar spine. Patient had lumbar epidural steroid injection previously without relief in symptoms. Following discussion of risk and benefits, patient opted for trial placement of spinal cord stimulator placement (SCS). Patient reported relief with SCS trial and decision was made for permanent SCS placement for long term pain control. We then placed two permanent octad leads bilaterally at the level of T8-9. Patient tolerated procedure well and was taken to the recovery room before going home that same day. At 3-month follow-up visits, patient continued to report 90% symptom relief with ability to increase activity and wean off of oral tramadol and gabapentin medications. Discussion: Our case adds to the growing body of literature illustrating the role of SCS in treating refractory pain caused by peripheral neuropathy from a variety of causes the mechanism of which is still being investigated.
Email: alaaawny@hotmail.com
