Long term clinical outcome of peripheral nerve stimulation in patients with chronic peripheral neuropathic pain

2010 ◽  
Vol 2010 ◽  
pp. 393-394
Author(s):  
S.E. Abram
Keyword(s):  
Neuropathic Pain ◽  
Clinical Outcome ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Peripheral Neuropathic Pain

Long term clinical outcome of peripheral nerve stimulation in patients with chronic peripheral neuropathic pain

2009 ◽  
Vol 72 (4) ◽  
pp. 330-335 ◽  
Author(s):  
Frank Van Calenbergh ◽  
Jan Gybels ◽  
Koen Van Laere ◽  
Patrick Dupont ◽  
Leon Plaghki ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Clinical Outcome ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Peripheral Neuropathic Pain

scholarly journals Peripheral Nerve Stimulation of the Lateral Femoral Cutaneous and Superior Gluteal Nerves for Treating Proximal Neuropathy Hip Pain

2020 ◽  
pp. 221-224
Author(s):  
Niek Vanquathem
Keyword(s):  
Drug Delivery ◽  
Spinal Cord ◽  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Spinal Cord Stimulation ◽  
Hip Pain ◽  
Peripheral Nerve Stimulation ◽  
Peripheral Neuropathic Pain ◽  
Intrathecal Drug Delivery

Background: Chronic postoperative hip pain is estimated to occur in 10% to 35% of patients undergoing total hip replacement. Proximal peripheral neuropathic pain of the lateral femoral cutaneous and superior gluteal nerves has proven to be a difficult disorder to treat. Opioids are often ineffective in the treatment of neuropathic pain. Interventional methods such as peripheral nerve stimulation are minimally invasive options capable of relieving neuropathic pain. Stimulators powered by an implantable pulse generator (IPG), however, may not be suitable for peripheral nerve stimulation because of difficulty finding an appropriate pocket site. The introduction of wireless peripheral nerve stimulation has improved the ability to offer this modality. Case Presentation: We present a case of proximal peripheral neuropathic pain of the lateral femoral cutaneous and superior gluteal nerves that failed all other treatment modalities including spinal cord stimulation and intrathecal drug delivery. Two quadripolar, tined, wireless electrode arrays were positioned over the lateral femoral cutaneous and superior gluteal nerves. A stimulation scheme with a pulse rate of 1.5 kHz and pulse width of 30 μs at 2.0 mA was tested and found effective. Conclusion: This patient had proximal neuropathic hip pain and failed a variety of chronic pain treatment options, including conventional IPG-based spinal cord stimulation and an intrathecal drug delivery system. She was successfully treated with a wireless peripheral nerve stimulation system. Key words: Hip pain, lateral femoral cutaneous nerve, peripheral nerve stimulator, peripheral neuropathy, superior gluteal nerve

Anatomic substrate of analgesia produced by long-term peripheral nerve stimulation in patients with neuropathic pain: a PET activation study

2007 ◽  
Vol 68 (2) ◽  
pp. 201
Author(s):  
F. Van Calenbergh ◽  
K. Van Laere ◽  
B. Depreitere ◽  
J. Gybels ◽  
L. Plaghki ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation

scholarly journals Long-Term Clinical Outcome of Peripheral Nerve Stimulation for Chronic Headache and Complication Prevention

2016 ◽  
Vol 6 (4) ◽  
Author(s):  
Linqiu Zhou ◽  
Avi Ashkenazi ◽  
Joseph W Smith ◽  
Na Jen ◽  
Timothy R Deer ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Chronic Headache ◽  
Peripheral Nerve Stimulation

scholarly journals Peripheral Nerve Stimulation of the Thoracic Paravertebral Plexus for Chronic Neuropathic Pain

2011 ◽  
Vol 3;14 (3;5) ◽  
pp. 295-300
Author(s):  
Dominic Hegarty
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Surgical Pain ◽  
Increased Risk ◽  
Clinical Awareness ◽  
Term Management ◽  
Stimulation Of

Persistent post surgical pain is reported in 70% of patients following thoracotomy and mastectomy. This pain is often neuropathic in nature and occasionally it is refractory to traditional medical and interventional management. Neurostimulation of peripheral nerves can be a highly effective clinical modality for the management of neuropathic pain. The placement of a percutaneously sited electrode in the thoracic paravertebral plexus offers a new and novel mode of managing refractory thoracic neuropathic pain. We present 2 cases that demonstrate the effectiveness of this intervention in the long-term management of this clinical dilemma. The first case presented is that of a 61-year-old female, with unilateral neuropathic pain for 6 years following mastectomy refractory to traditional interventions. Targeted field stimulation of the thoracic paravertebral plexus resulted in significant improvement for 12 years. The second case is that of a 65-year-old male, with Type II diabetes with neuropathic thoracic pain for 6 years following multiple rib fractures (T4-T7) who responded positively to neurostimulation of the thoracic paravertebral plexus. Both of these cases demonstrate a relative reduction in pain intensity (> 80%), the elimination of oral analgesics, and improved functionality directly related to the novel use of this intervention. Effective and reproducible pain relief is achieved by specifically using a low frequency (10 Hz) and low amplitude (2 mA) stimulation technique. Equally important is that these cases highlight the increased risk of inadvertent pleural puncture with the development of a pneumothorax that can be associated with this intervention. Possible clinical, investigative and equipment modifications that need to be considered are discussed. The limitations include only 2 case reports, considered as the lowest level of evidence available in the era of evidence-based medicine, and lack of utilization of multiple other modalities of treatments utilized in managing neuropathic pain. In conclusion, these cases demonstrate the effectiveness of peripheral nerve stimulation of the thoracic paravertebral plexus in the long-term management of refractory neuropathic pain. They also serve to underline the importance of clinical awareness in order to improve patient safety. Key words: Peripheral nerve stimulation, thoracic paravertebral plexus, persistent post surgical pain, neuropathic pain, pneumothorax

scholarly journals One Year Follow-up of a Randomized, Double-Blind, Placebo-Controlled Trial of Percutaneous Peripheral Nerve Stimulation for Chronic Neuropathic Pain Following Amputation

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Joshua M Rosenow ◽  
Christopher Gilmore ◽  
Brian M Ilfeld ◽  
Sean Li ◽  
Mehul J Desai ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Pain Interference ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo

Abstract INTRODUCTION Over 85% of patients experience residual limb (RLP) and/or phantom limb (PLP) pain following amputation. Peripheral nerve stimulation (PNS) is a non-opioid approach to relieve postamputation neuropathic pain. A recent multicenter, randomized, double-blind, placebo-controlled study using a novel percutaneous PNS system demonstrated clinically and statistically significant improvements in pain and pain interference with PNS compared to placebo (Gilmore et al, 2019). This work presents prospective 1-yr follow-up to assess durability of pain relief and functional improvements. METHODS Over 85% of patients experience residual limb (RLP) and/or phantom limb (PLP) pain following amputation. Peripheral nerve stimulation (PNS) is a non-opioid approach to relieve post-amputation neuropathic pain. A recent multicenter, randomized, double-blind, placebo-controlled study using a novel percutaneous PNS system demonstrated clinically and statistically significant improvements in pain and pain interference with PNS compared to placebo (Gilmore et al, 2019). This work presents prospective one-year follow-up to assess durability of pain relief and functional improvements. RESULTS A significantly greater proportion of subjects who completed the 12-mo visit reported = 50% pain relief on the BPI-SF (5/8, 63%; average pain relief = 73% among responders) compared to the placebo group at the time of crossover (0/14, 0%, P = .003; average pain relief = 23%). A majority of subjects also reported = 50% reductions in pain interference at 12 mo (5/8, 63%). Two of 13 (15%) subjects in the placebo group reported sustained improvements in pain interference (P = .06). Average reduction in pain interference among responders in the PNS group was 87%. CONCLUSION This work suggests that PNS delivered over 60 d may provide clinically significant and enduring pain relief, enabling improved function and potentially reducing the need for a permanently implanted system.

scholarly journals Percutaneous peripheral nerve stimulation for the treatment of chronic neuropathic postamputation pain: a multicenter, randomized, placebo-controlled trial

2019 ◽  
Vol 44 (6) ◽  
pp. 637-645 ◽  
Author(s):  
Christopher Gilmore ◽  
Brian Ilfeld ◽  
Joshua Rosenow ◽  
Sean Li ◽  
Mehul Desai ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Pain Interference ◽  
Controlled Study ◽  
Chronic Neuropathic Pain ◽  
Postamputation Pain

Background and objectivesChronic neuropathic pain is a common challenging condition following amputation. Recent research demonstrated the feasibility of percutaneously implanting fine-wire coiled peripheral nerve stimulation (PNS) leads in proximity to the sciatic and femoral nerves for postamputation pain. A multicenter, double-blinded, randomized, placebo-controlled study collected data on the safety and effectiveness of percutaneous PNS for chronic neuropathic pain following amputation.MethodsTwenty-eight lower extremity amputees with postamputation pain were enrolled. Subjects underwent ultrasound-guided implantation of percutaneous PNS leads and were randomized to receive PNS or placebo for 4 weeks. The placebo group then crossed over and all subjects received PNS for four additional weeks. The primary efficacy endpoint evaluated the proportion of subjects reporting ≥50% pain reduction during weeks 1–4.ResultsA significantly greater proportion of subjects receiving PNS (n=7/12, 58%, p=0.037) demonstrated ≥50% reductions in average postamputation pain during weeks 1–4 compared with subjects receiving placebo (n=2/14, 14%). Two subjects were excluded from efficacy analysis due to eligibility changes. Significantly greater proportions of PNS subjects also reported ≥50% reductions in pain (n=8/12, 67%, p=0.014) and pain interference (n=8/10, 80%, p=0.003) after 8 weeks of therapy compared with subjects receiving placebo (pain: n=2/14, 14%; pain interference: n=2/13, 15%). Prospective follow-up is ongoing; four of five PNS subjects who have completed 12-month follow-up to date reported ≥50% pain relief.ConclusionsThis work demonstrates that percutaneous PNS therapy may provide enduring clinically significant pain relief and improve disability in patients with chronic neuropathic postamputation pain.Trial registration numberNCT01996254.

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