P-PN032. Peripheral nerve hyperexcitability syndrome – Case series from tertiary neurospeciality centre

2021 ◽  
Vol 132 (8) ◽  
pp. e115
Author(s):  
Mayura P. Dhonde ◽  
Pramod V. Dhonde
2019 ◽  
Vol 9 (6) ◽  
pp. 551-558 ◽  
Author(s):  
Jessica Oswald ◽  
Varun Shahi ◽  
Krishnan V Chakravarthy

Aim: This case series looks at outcomes in 39 patients implanted using the Bioness Stimrouter system on various isolated mononeuropathies. Patients & methods: A case series of 39 patients with a total of 42 implants were enrolled starting August 2017 at various pain management centers. Results: Of 39 patients studied, 78% of the participants noticed an improvement in their pain. There was a 71% reduction in pain scores with the average preprocedure score of 8 improving to 2 post-implant. Participants noted on average a 72% improvement in activity with the greatest observed in the brachial plexus (80%) and suprascapular nerve (80%) and smallest in the intercostal nerve (40%). Approximately 89% of those implanted with a peripheral nerve stimulator experienced a greater than 50% reduction in opioid consumption. Conclusion: Peripheral nerve stimulators are a new, minimally invasive neuromodulation modality that shows promising early results in our 39-patient case series.


2021 ◽  
Vol 61 (5) ◽  
pp. 574-580
Author(s):  
Nicole M. Duggan ◽  
Arun Nagdev ◽  
Bryan D. Hayes ◽  
Hamid Shokoohi ◽  
Lauren A. Selame ◽  
...  

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 557-564 ◽  
Author(s):  
Brian M Ilfeld ◽  
Scott T Ball ◽  
Steven P Cohen ◽  
Steven R Hanling ◽  
Ian M Fowler ◽  
...  

Abstract Orthopedic trauma is a significant military problem, causing several of the most disabling conditions with high rates of separation from duty and erosion of military readiness. The objective of this report is to summarize the findings of case series of a non-opioid therapy—percutaneous peripheral nerve stimulation (PNS) – and describe its potential for postoperative analgesia, early opioid cessation, and improved function following orthopedic trauma. Percutaneous PNS has been evaluated for the treatment of multiple types of pain, including two case series on postoperative pain following total knee replacement (n = 10 and 8, respectively) and a case series on postamputation pain (n = 9). The orthopedic trauma induced during TKR is highly representative of multiple types of orthopedic trauma sustained by Service members and frequently produces intense, prolonged postoperative pain and extended opioid use following surgery. Collectively, the results of these three clinical studies demonstrated that percutaneous PNS can provide substantial pain relief, reduce opioid use, and improve function. These outcomes suggest that there is substantial potential for the use of percutaneous PNS following orthopedic trauma.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Birte Eikeland

Research in the last few years has indicated that most voltage-gated potassium channel- (VGKC-) complex antibodies without leucine-rich glioma-inactivated protein 1 or contactin-associated protein-like 2 antibody specificity lack pathogenic potential and are not clear markers for autoimmune inflammation. Here we report on a patient with double-negative VGKC who developed severe peripheral nerve hyperexcitability, central nervous system symptoms with agitation and insomnia, dysautonomia, and systemic symptoms with weight loss, itch, and skin lesions. The disease started acutely one month after an episode of enteroviral pericarditis and responded well to immunotherapy. The patient is presumed to have developed a postinfectious immunotherapy-responsive autoimmune disease. In the setting of anti-VGKC positivity, it seems likely that anti-VGKC contributed to the pathogenesis of the patient’s symptoms of nerve hyperexcitability and that the disease was caused by an acquired autoimmune effect on the neuronal kinetics of VGKC. It is still unknown whether or not there are unidentified extracellular molecular targets within the VGKC-complex, i.e., a novel surface antigen and a pathogenic antibody that can cause affected individuals to develop a peripheral nerve hyperexcitability syndrome. This case highlights the fact that less well-characterized autoimmune central and peripheral nervous system syndromes may have infectious triggers.


2017 ◽  
Vol 173 (10) ◽  
pp. 650-657 ◽  
Author(s):  
J. Franques ◽  
P. Sahuc ◽  
B. Dussol ◽  
G. Penaranda ◽  
L. Swiader ◽  
...  

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