Premium
High‐Frequency Supraorbital Nerve Stimulation With a Novel Wireless Minimally Invasive Device for Post‐Traumatic Neuralgia: A Case Report
Author(s) -
Van Buyten JeanPierre,
Smet Iris,
Devos Marieke,
Vanquathem Niek E.
Publication year - 2019
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12747
Subject(s) - medicine , occipital nerve stimulation , surgery , percutaneous , supraorbital nerve , pulsed radiofrequency , anesthesia , trigeminal neuralgia , neuralgia , deep brain stimulation , neuropathic pain , pain relief , alternative medicine , disease , pathology , reflex , corneal reflex , parkinson's disease
Background Post‐traumatic neuropathic pain in the head and face is a condition that is often refractory to medical management. Peripheral nerve stimulation ( PNS ) can be an effective treatment. Successful implantation of a novel minimally invasive wireless device is reported here. Objective To assess analgesic effects of a minimally invasive wireless PNS device in the treatment of post‐traumatic supraorbital neuralgia ( SON ). Case Summary The patient presented with SON following multiple post‐traumatic cranioplasty surgeries, which were complicated by infections. Medical and interventional management failed, and the patient reported a numeric rating scale ( NRS ) pain score of 8 out of 10. Two octopolar implantable neural stimulators ( INSs ) (StimRelieve LLC , Pompano Beach, FL , U.S.A. ) were implanted with a minimally invasive, percutaneous technique to stimulate the supraorbital nerves. Stimulation parameters were set at a frequency of 10 kHz and a pulse width of 30 microseconds. Results At 12‐ and 24‐month follow‐up evaluations, the patient's NRS score was only 2 out of 10, and the patient occasionally required 1 g of paracetamol to control the pain. Stimulation was reported to be paresthesia free. There were no adverse events related to the procedure or the treatment until today. Conclusions High‐frequency stimulation with an external pulse generator and minimally invasive, percutaneous, and bilateral placement of 2 passive INSs on the supraorbital nerves resulted in a significant pain relief in this patient with post‐traumatic SON . The device was safe and effective, and the cosmesis was satisfactory.