scholarly journals Abdominal wall Type-I complex regional pain syndrome treated effectively with peripheral nerve field stimulation: a case report

2017 ◽  
Vol 2017 (1) ◽  
pp. rjw222 ◽  
Author(s):  
Linqiu Zhou ◽  
Henry Chou ◽  
Eric Holder
2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.


2019 ◽  
Vol 19 (4) ◽  
pp. 829-835 ◽  
Author(s):  
Daniel Herschkowitz ◽  
Jana Kubias

Abstract Background Complex regional pain syndrome (CRPS) is a chronic disabling painful disorder with limited options to achieve therapeutic relief. CRPS type I which follows trauma, may not show obvious damage to the nervous structures and remains dubious in its pathophysiology and also its response to conservative treatment or interventional pain management is elusive. Spinal cord and dorsal root ganglion stimulation (SCS, DRGS) provide good relief, mainly for causalgia or CRPS I of lower extremities but not very encouraging for upper extremity CRPS I. we reported earlier, a case of CRPS I of right arm treated successfully by wireless peripheral nerve stimulation (WPNS) with short term follow up. Here we present 1-year follow-up of this patient. Objective To present the first case of WPNS for CRPS I with a year follow up. The patient had minimally invasive peripheral nerve stimulation (PNS), without implantable pulse generator (IPG) or its accessories. Case report This was a case of refractory CRPS I after blunt trauma to the right forearm of a young female. She underwent placement of two Stimwave electrodes (Leads: FR4A-RCV-A0 with tines, Generation 1 and FR4A-RCV-B0 with tines, Generation 1) in her forearm under intraoperative electrophysiological and ultrasound guidance along radial and median nerves. This WPNS required no IPG. At high frequency (HF) stimulation (HF 10 kHz/32 μs, 2.0 mA), patient had shown remarkable relief in pain, allodynia and temperature impairment. At 5 months she started driving without opioid consumption, while allodynia disappeared. At 1 year follow up she was relieved of pain [visual analogue scale (VAS) score of 4 from 7] and Kapanji Index (Score) improved to 7–8. Both hands look similar in color and temperature. She never made unscheduled visits to the clinic or visited emergency room for any complications related to the WPNS. Conclusions CRPS I involving upper extremity remain difficult to manage with conventional SCS or DRGS because of equipment related adverse events. Minimally invasive WPNS in this case had shown consistent relief without any complications or side effects related to the wireless technology or the technique at the end of 1 year. Implications This is the first case illustration of WPNS for CRPS I, successfully treated and followed up for 1 year.


2015 ◽  
Vol 38 (2) ◽  
pp. 121-130 ◽  
Author(s):  
Jan H.B. Geertzen ◽  
Marlies I. Bodde ◽  
Jan J.A. van den Dungen ◽  
Pieter U. Dijkstra ◽  
Wilfred F.A. den Dunnen

Ból ◽  
2019 ◽  
Vol 19 (4) ◽  
pp. 59-62
Author(s):  
Osman Chaudhary ◽  
Teodor Goroszeniuk ◽  
Christopher Chan

Chronic pain attributed to the abdominal wall is seen in 10-30% of patients who present to specialist pain clinics [24]. The most common cause is abdominal cutaneous nerve entrapment syndrome (ACNES). Trauma, including surgical incisions and tissue scarring, are well accepted causes of cutaneous nerve entrapment causing neuropathic pain [24]. The occurrence of peristomal neuropathic pain associated with an ileal-conduit formation is rare. A case of chronic cutaneous peristomal pain of the abdominal wall, refractory to conventional pharmacological therapies is described. The technique of peripheral nerve field stimulation (PNFS) for the successful management of peristomal neuropathic abdominal wall pain is reported.


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