scholarly journals Spinal Cord Stimulation for Complex Regional Pain Syndrome: A Case Study of a Pregnant Female

2016 ◽  
Vol 3;19 (3;3) ◽  
pp. E487-E493
Author(s):  
Shaik Ahmed
Keyword(s):  
Spinal Cord ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Treatment Options ◽  
Pain Syndrome ◽  
Conclusive Evidence ◽  
Treatment Modalities ◽  
Child Bearing ◽  
The Impact

Background: Spinal cord stimulation (SCS) is a form of neuromodulation, used to treat chronic neuropathic pain refractory to conventional medical management. Spinal cord stimulators are treatment options when intractable chronic pain has not responded to more conventional treatment modalities. Currently, the use of SCS is contraindicated in pregnancy. Nevertheless, many SCS/ neuromodulation recipients are women of child bearing age who may become pregnant. There are no published reports that focus on the possible side effects of SCS or neuromodulation therapy on human fertility, fetal development, pregnancy, delivery, or lactation. Objectives: The purpose of this current report is to present a case study on the use of SCS/ neuromodulation during pregnancy. Study Design: Presentation of the case of a 24 year old female who became pregnant after receiving an SCS implantation for pain control secondary to complex regional pain syndrome (CRPS). The SCS was in use at the time of conception but deactivated when patient became aware of her pregnancy and intermittently reactivated for five minute intervals throughout the entire pregnancy. Results: Currently very little documented evidence is available regarding the safety of using a SCS/ neuromodulator during pregnancy; therefore its use during pregnancy is contraindicated. Available literature suggests that, women who have chosen to keep the SCS/neuromodulator activated during pregnancy have delivered healthy babies without any life threatening complications. Limitations: Case presentations do not provide conclusive evidence of treatment effectiveness. This data is only preliminary and future studies should be used to assess outcomes and measures to provide quantification of the SCS implantation during pregnancy. Conclusions: Women of child bearing age who are recipients of SCS/neuromodulation implantation should be informed of the limited knowledge available regarding the impact of SCS/ neuromodulation use during pregnancy. For current recipients, decisions about ongoing use during pregnancy should be an individual decision based on the potential risks and benefits. Key words: Pregnancy and complex regional pain syndrome, pregnancy and reflex sympathetic dystrophy, pregnancy and spinal cord stimulators, pregnancy and electromagnetic fields, and pregnancy and neuromodulator.

The Impact of Tobacco Smoking on Spinal Cord Stimulation Effectiveness in Complex Regional Pain Syndrome Patients

2019 ◽  
Vol 23 (1) ◽  
pp. 133-139 ◽  
Author(s):  
Nagy Mekhail ◽  
Shrif Costandi ◽  
Diana S. Mehanny ◽  
Sherif Armanyous ◽  
Ogena Saied ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Complex Regional Pain Syndrome ◽  
Tobacco Smoking ◽  
Spinal Cord Stimulation ◽  
Pain Syndrome ◽  
The Impact

Effect of spinal cord stimulation in Type I complex regional pain syndrome with 2 rare severe cutaneous manifestations

2009 ◽  
Vol 110 (2) ◽  
pp. 274-278
Author(s):  
Kim Rijkers ◽  
Jasper van Aalst ◽  
Erkan Kurt ◽  
Marc A. Daemen ◽  
Emile A. M. Beuls ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Complex Regional Pain Syndrome ◽  
Female Patient ◽  
Spinal Cord Stimulation ◽  
Scientific Literature ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type ◽  
Cutaneous Manifestations ◽  
Giant Bullae

The authors present the case of a 49-year-old female patient with complex regional pain syndrome–Type I (CRPSI) who was suffering from nonhealing wounds and giant bullae, which dramatically improved after spinal cord stimulation (SCS). The scientific literature concerning severe cutaneous manifestations of CRPS-I and their treatment is reviewed. Nonhealing wounds and bullae are rare manifestations of CRPS-I that are extremely difficult to treat. Immediate improvement of both wounds and bullae after SCS, such as in this case, has not been reported previously in literature. Considering the rapidly progressive nature of these severe skin manifestations, immediate treatment, possibly with SCS, is mandatory.

scholarly journals Spinal cord stimulation for complex regional pain syndrome type 1 with dystonia: a case report and discussion of the literature

F1000Research ◽  
2014 ◽  
Vol 3 ◽  
pp. 97 ◽  
Author(s):  
Caroline Voet ◽  
Bernard le Polain de Waroux ◽  
Patrice Forget ◽  
Ronald Deumens ◽  
Etienne Masquelier
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Case Report ◽  
Complex Regional Pain Syndrome ◽  
Spinal Cord Stimulation ◽  
Behavioural Change ◽  
Pain Syndrome ◽  
Social Model ◽  
Syndrome Type

Background: Complex Regional Pain Syndrome type 1 (CRPS-1) is a debilitating chronic pain disorder, the physiopathology of which can lead to dystonia associated with changes in the autonomic, central and peripheral nervous system. An interdisciplinary approach (pharmacological, interventional and psychological therapies in conjunction with a rehabilitation pathway) is central to progress towards pain reduction and restoration of function.Aim: This case report aims to stimulate reflection and development of mechanism-based therapeutic strategies concerning CRPS associated with dystonia.Case description: A 31 year old female CRPS-1 patient presented with dystonia of the right foot following ligamentoplasty for chronic ankle instability. She did not have a satisfactory response to the usual therapies. Multiple anesthetic blocks (popliteal, epidural and intrathecal) were not associated with significant anesthesia and analgesia. Mobilization of the foot by a physiotherapist was not possible. A multidisciplinary approach with psychological support, physiotherapy and spinal cord stimulation (SCS) brought pain relief, rehabilitation and improvement in the quality of life.Conclusion: The present case report demonstrates the occurrence of multilevel (peripheral and central) pathological modifications in the nervous system of a CRPS-1 patient with dystonia. This conclusion is based on the patient’s pain being resistant to anesthetic blocks at different levels and the favourable, at least initially, response to SCS. The importance of the bio-psycho-social model is also suggested, permitting behavioural change.

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