scholarly journals A Unique Case for Spinal Cord Stimulation: Successful Treatment of Small Fiber Neuropathy Pain Using Multiple Spinal Cord Stimulators

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Maxim Eckmann ◽  
Alexander Papanastassiou ◽  
Mark Awad
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Case Report ◽  
Poor Quality ◽  
Small Fiber Neuropathy ◽  
Entire Body ◽  
Full Time ◽  
Unique Case ◽  
Small Fiber

Spinal cord stimulators have commonly been used to treat multiple pain conditions. This case report represents a unique case of using multiple spinal cord stimulators for widespread small fiber neuropathy pain. This case report concerns patient JJ who first presented with generalized neuropathic pain. His pain was an intermittent burning, stinging quality that originally focused in both of his feet and progressed to include his legs and arms and eventually involved his entire body. The pain would last moments to hours at least daily. He reported a poor quality of life. He was diagnosed with small fiber neuropathy with anhydrosis, suggestive of idiopathic erythromelalgia. He had a spinal cord stimulator trial involving both cervical and lower thoracic percutaneous leads. After two spinal cord stimulators were implanted, the patient began to report an improvement in pain. The patient continues to report excellent pain relief. The patient uses the stimulator intermittently as needed, in an abortive fashion for pain flares. The patient is very pleased and has increased his activity. He now attends graduate school full time. This case report hopes to illustrate a unique use of multiple spinal cord stimulators in treating widespread neuropathic pain caused by small fiber neuropathy.

scholarly journals Efficacious Dorsal Root Ganglion Stimulation for Painful Small Fiber Neuropathy: A Case Report

2017 ◽  
Vol 3 (20;3) ◽  
pp. E459-E463 ◽  
Author(s):  
Eva Koetsier
Keyword(s):  
Neuropathic Pain ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Rating Scale ◽  
Pain Treatment ◽  
Small Fiber Neuropathy ◽  
Intractable Pain ◽  
Positive Trial ◽  
Small Fiber

Small fiber neuropathy is a disorder of the peripheral nerves with typical symptoms of burning, sharp, and shooting pain and sensory disturbances in the feet. Pain treatment depends principally on the underlying etiology with concurrent administration of antidepressants, anticonvulsants, opioids, and topical treatments like capsaicin and local anesthetics. However, treatments for pain relief in these patients frequently fail. We describe the first case of intractable painful small fiber neuropathy of the foot successfully treated with spinal cord stimulation of the left L5 dorsal root ganglion. A 74-year-old man presented at our clinic with severe intractable pain, dysesthesia, and allodynia of the left foot caused by idiopathic small fiber neuropathy, confirmed by skin biopsy. His pain score was 8 on a standard 0 – 10 numeric rating scale. As the pain was not satisfactorily controlled by conventional therapy, dorsal root ganglion stimulation was proposed to the patient and, after informed consent, a specifically designed percutaneous stimulation lead was placed over the left L5 dorsal root ganglion and connected to an external neurostimulator. After a positive trial of 10 days, a permanent neurostimulator was implanted. Twenty months post-implantation the patient continued to experience stimulation-induced paresthesia covering the entire pain area and reported a pain rating of 4. Results from the case report demonstrate that the dorsal root ganglion is a promising neural stimulation target to treat neuropathic pain due to intractable small fiber neuropathy. Prospective controlled studies are warranted to confirm the efficacy of this treatment as an option for the aforementioned condition. Key words: Dorsal root ganglion stimulation, small fiber neuropathy, neuropathic pain

Neuropathic pain and symptoms of potential small-fiber neuropathy in fibromyalgic patients: A national on-line survey

2021 ◽  
Vol 88 (4) ◽  
pp. 105153 ◽  
Author(s):  
Antonello Viceconti ◽  
Tommaso Geri ◽  
Simone De Luca ◽  
Filippo Maselli ◽  
Giacomo Rossettini ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Small Fiber Neuropathy ◽  
Small Fiber ◽  
On Line ◽  
Line Survey

scholarly journals Spinal Cord Stimulation as a Treatment Option for Refractory Chemotherapy-Induced Peripheral Neuropathy: Case Report

2020 ◽  
Vol 39 (03) ◽  
pp. 228-231 ◽  
Author(s):  
Arthur Lopes ◽  
Kleber Duarte ◽  
Catarina Lins ◽  
Gabriel Kubota ◽  
Valquíria Silva ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Spinal Cord ◽  
Neuropathic Pain ◽  
Case Report ◽  
Peripheral Neuropathy ◽  
Treatment Option ◽  
Spinal Cord Stimulation ◽  
Lower Limbs ◽  
Oncological Diseases ◽  
Good Treatment Option

AbstractColorectal cancer is one of the most common oncological diseases. Chemotherapy is usually recommended as an adjuvant treatment for stage-II, -III, and -IV tumors. Approximately 10% of the patients develop neuropathic pain after chemotherapy, and they may remain refractory despite the administration of drugs that are commonly used to treat neuropathic pain. Spinal cord stimulation is a good treatment option for neuropathic pain of the lower limbs, and it should be trialed in patients with chemotherapy-induced peripheral neuropathy. We report the case of a patient with oxaliplatin-induced neuropathy and neuropathic pain refractory to oral medication who was successfully treated by spinal cord stimulation.

scholarly journals Long-Time Course of Idiopathic Small Fiber Neuropathy

2018 ◽  
Vol 79 (3-4) ◽  
pp. 161-165 ◽  
Author(s):  
Pia Flossdorf ◽  
Walter F. Haupt ◽  
Anna Brunn ◽  
Martina Deckert ◽  
Gereon R. Fink ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Time Course ◽  
Benign Disease ◽  
Small Fiber Neuropathy ◽  
Disease Course ◽  
Peripheral Neuropathies ◽  
Small Fiber ◽  
Long Time ◽  
Large Fiber

Background: Small fiber neuropathy (SFN) is a challenging subtype of peripheral neuropathies. Once the diagnosis has been established, there is an uncertainty how SFN may progress, whether larger fibers will become involved over time, whether quality of life may be compromised, or whether repeated diagnostic workup in patients with unknown underlying cause may increase the yield of treatable causes of SFN. Methods: We evaluated 16 patients with documented long-time course of idiopathic SFN. Results: Clinical and electrophysiological course remained stable in 75% of the patients, while 25% SFN-patients developed large fiber neuropathies. Conclusions: Our data suggest that SFN represents a benign disease course in the majority of patients without severely limiting the quality of life.

Small Fiber Neuropathy

2019 ◽  
Vol 39 (05) ◽  
pp. 570-577 ◽  
Author(s):  
Lan Zhou
Keyword(s):  
Skin Biopsy ◽  
Lifestyle Modification ◽  
Specific Treatment ◽  
Small Fiber Neuropathy ◽  
Fiber Density ◽  
Small Fiber ◽  
Intraepidermal Nerve Fiber Density ◽  
Associated Conditions ◽  
Density Evaluation

AbstractSmall fiber neuropathy (SFN) is common, and can be associated with many medical conditions. The majority of the patients with SFN suffer from painful paresthesia which can negatively impact their quality of life. Skin biopsy with intraepidermal nerve fiber density evaluation is the gold standard diagnostic test. Autonomic function testing is useful when autonomic symptoms are present. Screening for associated conditions should be done in every patient, even when a known underlying associated condition is present, before the neuropathy evaluation. Etiology-specific treatment, lifestyle modification, and pain control are the key elements of SFN management. This article will review the clinical presentation, skin biopsy procedure, utility of diagnostic tests, associated conditions, management, and prognosis of SFN.

scholarly journals Managing two decades of visceral leishmaniasis and HIV co-infection: a case report that illustrates the urgent research needs in the field

Sexual Health ◽  
2017 ◽  
Vol 14 (3) ◽  
pp. 286 ◽  
Author(s):  
Melissa L. Kelly ◽  
Angie N. Pinto ◽  
Dan Suan ◽  
Debbie Marriott ◽  
David A. Cooper ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Side Effects ◽  
Visceral Leishmaniasis ◽  
Liver Failure ◽  
Infected Patient ◽  
Poor Quality ◽  
Research Needs ◽  
Treatment Side Effects

Visceral leishmaniasis and HIV co-infection presents diagnostic, monitoring and treatment challenges. This is a report of a co-infected patient who developed multiple complications and treatment side-effects, including renal and liver failure, pancytopenia with recurrent sepsis, along with anal cancer, depression and poor quality-of-life spanning over two decades. Urgent research specific to this cohort is needed.

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