scholarly journals Percutaneous Peripheral Nerve Stimulation for Treatment of Brachial Plexopathy Secondary to Pancoast Tumor: A Case Report

2020 ◽  
pp. 169-174
Author(s):  
Varun Channagiri
Keyword(s):  
Case Report ◽  
Pain Management ◽  
Peripheral Nerve ◽  
Physical Examination ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Brachial Plexopathy ◽  
Pancoast Tumor ◽  
Lower Trunk ◽  
Pancoast Tumors

Background: Pancoast tumors can result in significant arm and shoulder pain due to invasion of the lower brachial plexus (BP). They are usually treated by chemoradiotherapy followed by surgical resection, which may alleviate the pain. When patients respond poorly to chemoradiation and the tumor is not surgically resectable, options to treat the pain are limited. We report here successful use of percutaneous peripheral nerve stimulation (PNS) with leads inserted under ultrasound (US)-guidance for treatment of brachial plexopathy in a patient with an unresectable Pancoast tumor unresponsive to chemoradiation. Case Report: The patient was a 70-year-old woman with an unresectable poorly differentiated squamous cell carcinoma of the left lung status post chemoradiation with poor response and recently started on immune therapy who presented to her oncologist with refractory left upper extremity (LUE) pain and weakness. She was admitted for pain control, and pain management was consulted. Physical examination findings were concerning for involvement of the lower trunk of the BP, findings confirmed in imaging. Patient elected to proceed with placement of a PNS. Device was successfully placed under US guidance. Patient responded well for the first 2 weeks with significant improvement in allodynia and hyperesthesia, however, at week 3, physical examination was significantly changed and further growth of the tumor was seen on imaging. The PNS was removed at this time. Conclusion: This case demonstrates successful use of PNS to treat refractory neuropathic pain in a patient with a locally advanced Pancoast tumor. US imaging made it possible to identify the interscalene BP and accurately place the leads. The PNS achieved its desired outcome of providing pain relief in the lower trunk distribution for the full 3 weeks it was in place. Pain from Pancoast tumors can be severe, and neural blockade via PNS to interrupt pain is an option for patients with intractable pain. Additional prospective study is warranted to determine the efficacy of this technique. Key words: Brachial plexus, upper extremity, cancer pain, interventional pain management, neuromodulation, peripheral nerve stimulation

scholarly journals Percutaneous peripheral nerve stimulation for treatment of shoulder pain after spinal cord injury: A case report

2017 ◽  
Vol 41 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Daniela Mehech ◽  
Melvin Mejia ◽  
Gregory A. Nemunaitis ◽  
John Chae ◽  
Richard D. Wilson
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Case Report ◽  
Peripheral Nerve ◽  
Shoulder Pain ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Cord Injury

scholarly journals Peripheral Nerve Stimulation for Treatment of Painful Osteoarthritis of the Knee: A Case Report

2021 ◽  
pp. 201-204
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Peripheral Nerve ◽  
Knee Pain ◽  
Nerve Stimulation ◽  
Short Form ◽  
Pain Modulation ◽  
Peripheral Nerve Stimulation ◽  
Osteoarthritis Of The Knee ◽  
Osteoarthritic Knee

BACKGROUND: Osteoarthritic knee (OAk) pain is common, yet the standard of care often yields unsatisfactory pain relief. There remains a role for novel treatment options. Percutaneous motor peripheral nerve stimulation (mPNS) of the knee is a novel minimally invasive procedure that stimulates motor end points leading to muscle contraction associated with the painful joint. Pain relief is hypothesized to be achieved through central pain modulation. CASE REPORT: We report the case of a patient who experienced refractory osteoarthritic knee pain after 9 months of conservative care. Following 7 weeks of mPNS treatment, the patient achieved improvement in OAk pain relief and activities of daily living as measured by notable improvements in the Brief Pain Inventory-Short Form and Knee Injury and Osteoarthritis Outcome Score at 8- and 12-weeks postimplant. The Patient Global Impression of Change at the end of stimulation was much improved. CONCLUSION: Motor PNS may offer a safe and effective treatment alternative for chronic refractory pain related to OAk. KEY WORDS: Osteoarthritis, knee, pain, peripheral nerve stimulation

A case report of wireless peripheral nerve stimulation for complex regional pain syndrome type-I of the upper extremity: 1 year follow up

2019 ◽  
Vol 19 (4) ◽  
pp. 829-835 ◽  
Author(s):  
Daniel Herschkowitz ◽  
Jana Kubias
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Peripheral Nerve ◽  
Upper Extremity ◽  
Nerve Stimulation ◽  
Pain Syndrome ◽  
Peripheral Nerve Stimulation ◽  
Type I ◽  
First Case

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.

scholarly journals Peripheral Nerve Stimulation for the Treatment of Postamputation Pain-A Case Report

Pain Practice ◽  
2012 ◽  
Vol 12 (8) ◽  
pp. 649-655 ◽  
Author(s):  
Richard L. Rauck ◽  
Leonardo Kapural ◽  
Steven P. Cohen ◽  
James M. North ◽  
Christopher A. Gilmore ◽  
...  
Keyword(s):  
Case Report ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Postamputation Pain

scholarly journals Wireless Peripheral Nerve Stimulation for the Treatment of Chronic Shoulder Pain

2021 ◽  
pp. 13-17
Author(s):  
Niek Vanquathem
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Peripheral Nerve ◽  
Shoulder Pain ◽  
Nerve Stimulation ◽  
Invasive Procedure ◽  
Peripheral Nerve Stimulation ◽  
Patient Reported ◽  
Glenohumeral Osteoarthritis ◽  
Chronic Shoulder Pain

Background: Shoulder pain is a common condition, often refractory to treatment. Peripheral nerve stimulation (PNS) of the suprascapular nerve (SSN) can be efficacious in providing relief of shoulder pain while improving pain-related quality of life (QOL). The objective of this case report is to demonstrate the effectiveness of a minimally invasive wireless PNS in the treatment of chronic shoulder pain. Case Report: This 94-year old man presented with severe shoulder pain. He suffered from poliomyelitis as a child affecting his left leg, forcing him to use crutches to be ambulatory. He developed progressive right shoulder pain and was subsequently diagnosed with right glenohumeral osteoarthritis. The patient was treated semiannually for 4 years with corticosteroids injections and pain medication with minimal relief (7 out of 10 on the Visual Analog Scale [VAS]). A suprascapular block with lidocaine 2% resulted in significant pain reduction (1 out of 10 on the VAS). As a result, the patient opted for wireless PNS of the SSN via a minimally invasive procedure. Two weeks post implant, the patient reported no postoperative pain, and his chronic pain was rated 0 out of 10 even during movement. Reports of reduced pain were sustained throughout the 6 months of observation with subsequent improvements in QOL and functionality. Conclusion: Wireless neurostimulation of the SSN can be a very effective therapy option for the treatment of refractory, chronic shoulder pain as a result of glenohumeral osteoarthritis. Key words: Endoscopic spine surgery, lumbar radiculopathy, minimally invasive spine, SI joint fusion

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