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Efficacy of High-Frequency Spinal Cord Stimulation in Idiopathic Asymmetrical Small-Fiber Neuropathy Case Report. 高频脊髓刺激治疗特发性不对称小纤维神经病的疗效报告。
Pain medicine case reports Pub Date : 2024-07-01
Vahid Mohabbati, Parsa Mohabbati, Mohammadkazem Papan
{"title":"Efficacy of High-Frequency Spinal Cord Stimulation in Idiopathic Asymmetrical Small-Fiber Neuropathy Case Report.","authors":"Vahid Mohabbati, Parsa Mohabbati, Mohammadkazem Papan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND: Small-fiber neuropathies (SFNs), affecting thinly myelinated Ad fibers and unmyelinated C fibers, often manifest with sensory or autonomic symptoms in varied patterns. Diagnostic tools comprise skin biopsy, quantitative sensory, autonomic testing, and biochemical markers. Spinal cord stimulation (SCS), particularly high-frequency SCS, has emerged as a pivotal therapeutic intervention. \u0000\u0000CASE REPORT: This study delves into a 49-year-old woman diagnosed with idiopathic asymmetrical SF peripheral neuropathy, examining her 12-month postoperative trajectory after SCS implantation. Postsurgical assessment revealed substantial improvements: baseline pain (Numeric Rating Scale 7) decreased to 4 at 3 months, indicating reduced intensity; Oswestry Disability Index improved from 38% to 4%, highlighting enhanced functionality; Patient-Specific Questionnaire 3 average score dropped from 35 to 2, indicating improved outcomes in specific pain-related concerns. \u0000\u0000CONCLUSIONS: This case report underscores the efficacy of SCS in managing idiopathic asymmetrical SFN, demonstrating significant symptomatic relief over a 12-month postoperative period.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 5","pages":"185-190"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-Term Efficacy of a Novel Extraforaminal Approach for Nerve Root Stimulation in Complex Regional Pain Syndrome: A Case Report. 一种新型椎间孔外入路神经根刺激治疗复杂局部疼痛综合征的长期疗效：1例报告。
Pain medicine case reports Pub Date : 2024-07-01
Danielle Kohr, Sudhir Diwan, Michael Kugler
{"title":"Long-Term Efficacy of a Novel Extraforaminal Approach for Nerve Root Stimulation in Complex Regional Pain Syndrome: A Case Report.","authors":"Danielle Kohr, Sudhir Diwan, Michael Kugler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND: Neuromodulation techniques can be employed as part of the treatment approach for refractory complex regional pain syndrome (CRPS). \u0000\u0000CASE REPORT: We present a case report of a 62-year-old male patient with CRPS of the lower limb who underwent spinal nerve root stimulation using a novel extraforaminal lead placement as a treatment modality after the failed replacement of a defective dorsal root ganglion lead. This case report highlights the successful long-term application of dorsal nerve root stimulation with an alternative extraforaminal lead placement technique, resulting in significant pain relief and improved functional outcomes in a patient with refractory CRPS. \u0000\u0000CONCLUSIONS: </strong>The novel anatomical approach and neurostimulation technique described in this case provide a promising alternative for patients who have not responded to other treatment modalities.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 5","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peripheral Nerve Stimulation Using High-Frequency Electromagnetic Coupling Technology to Power an Implanted Neurostimulator With a Separate Receiver for the Treatment of Peripheral Neuropathy. 利用高频电磁耦合技术为带有单独接收器的植入式神经刺激器供电，用于周围神经病变的治疗。
Pain medicine case reports Pub Date : 2024-07-01
Aaron Mates
{"title":"Peripheral Nerve Stimulation Using High-Frequency Electromagnetic Coupling Technology to Power an Implanted Neurostimulator With a Separate Receiver for the Treatment of Peripheral Neuropathy.","authors":"Aaron Mates","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND: Chronic pain impacts multiple facets of daily life, including mental health, mobility, and ability to work. Conservative management strategies often fail to control pain adequately, and pharmaceutical treatments involve unwanted side effects. With the development of specialized technology, peripheral nerve stimulation (PNS) has emerged as a treatment for pain caused by peripheral neuralgias that cannot be managed with conservative strategies. \u0000\u0000CASE REPORT: This was a retrospective study collecting data from the electronic medical records of patients. A chart review was conducted for all eligible study patients. Patients who underwent a PNS trial for the treatment of peripheral neuropathy were recruited to participate in this study. Verbal Rating Scale (VRS) scores decreased from 7.8 ± 1.6 to 1.6 ± 1.1 after the trial. At 3 months, VRS scores decreased to 2.1 ± 2.7. \u0000\u0000CONCLUSIONS: The Freedom<sup>®</sup> PNS System is a safe and effective treatment modality for the management of pain caused by peripheral neuropathy.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 5","pages":"173-177"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Not Always Crystal Clear: Pseudogout as a Cause of Lumbar Radicular Pain-A Case Report. 假性麻痹是腰椎神经根痛的原因，并非总是十分清楚——一个病例报告。
Pain medicine case reports Pub Date : 2024-07-01
Robin Mata, Lorenzo Diaz, Chane Price
{"title":"Not Always Crystal Clear: Pseudogout as a Cause of Lumbar Radicular Pain-A Case Report.","authors":"Robin Mata, Lorenzo Diaz, Chane Price","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND: Calcium pyrophosphate crystal deposition (CPPD) also known as \"pseudogout\" is a lesser-known cause of radicular pain that can occur in the spine after surgical intervention. Crystals may deposit extradurally in the ligamentum flavum, facet joints, and intervertebral discs causing symptoms ranging from mild-to-intractable radicular pain or cauda equina syndrome. CASE REPORT: A 60-year-old man with a history of multiple lumbar surgeries and recent right L2-L3 hemilaminectomy/facetectomy presented with severe, radicular pain. Physical exam demonstrated decreased left L5 dermatome sensation. Postop imaging confirmed worsening foraminal encroachment at L5-S1 compared to preop imaging. The patient failed steroid taper, neuropathic agents, nonsteroidal anti-inflammatory drugs, physical therapy, and 3 L5-S1 epidural steroid injections. He ultimately underwent L5-S1 microdiscectomy where numerous crystalline deposits were identified and sent for pathology, revealing CPPD with foamy histiocytes. CONCLUSIONS: Clinicians should consider CPPD in at-risk patients with radicular pain following surgery to expedite appropriate workup and rheumatologic management.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 5","pages":"191-193"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infrapatellar Branch of the Saphenous Nerve Radiofrequency Ablation for Refractory Knee Pain: Case Series. 髌下隐神经支射频消融术治疗顽固性膝关节疼痛：病例系列。
Pain medicine case reports Pub Date : 2024-07-01
Sajal Kulhari, Nafis Eghrari, Matthew Chen, Nikhil Grandhi, Chong Kim
{"title":"Infrapatellar Branch of the Saphenous Nerve Radiofrequency Ablation for Refractory Knee Pain: Case Series.","authors":"Sajal Kulhari, Nafis Eghrari, Matthew Chen, Nikhil Grandhi, Chong Kim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>BACKGROUND: Chronic knee pain (CKP) is common, and one of the treatment options includes the targeting of the genicular nerves with radiofrequency ablation (RFA). RFA of the genicular nerve or genicular nerve ablation (GNA) for CKP, traditionally includes several nerves, the superior lateral, superior medial, and inferior medial. More recently, other nerves, such as the infrapatellar branch of the saphenous nerve (IFBS), have been investigated. \u0000\u0000CASE REPORT: Four patients with mostly refractory inferior medial CKP who were all nonresponsive to conservative treatments were evaluated for treatment for GNA. All the patients underwent traditional genicular nerve blocks (superior lateral, superior medial, and inferior medial) under fluoroscopy and failed to obtain relief of > 50%. Subsequently, these 4 patients underwent successful IFBS nerve blocks and RFA. \u0000\u0000CONCLUSIONS: GNA is a treatment option for patients with CKP. Despite the growing evidence of support for GNA, other targets, such as the IFBS, may be more appropriate to include or target specifically and may be considered based on the location of pain or response to traditional targets.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 5","pages":"195-197"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Herpes Simplex Virus-1 Complicated by Postherpetic Neuralgia: A Case Report. 单纯疱疹病毒-1并发带状疱疹后神经痛1例
Pain medicine case reports Pub Date : 2024-05-01
Esha Jain, Erica Eldon, Lisa Witkin, Julia Cron
{"title":"Herpes Simplex Virus-1 Complicated by Postherpetic Neuralgia: A Case Report.","authors":"Esha Jain, Erica Eldon, Lisa Witkin, Julia Cron","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The following case describes management of severe persistent vulvar pain from postherpetic neuralgia through a ganglion impar block.</p><p><strong>Case report: </strong>A 21-year-old female patient initially presented with genital lesions consistent with herpes simplex virus-1 (HSV-1) and antibody testing suggestive of primary HSV-1 infection. After her genital lesions resolved, she continued to have severe persistent vulvar pain and was diagnosed with postherpetic neuralgia, approximately one year after initial presentation. After unsuccessful medical management with her gynecologist and primary care physician, she was referred to a specialty pain management clinic, where a ganglion impar block was performed and provided significant pain relief.</p><p><strong>Conclusions: </strong>Genital HSV-1 is a rare cause of postherpetic neuralgia which can cause debilitating pain. Its management requires a multidisciplinary approach, including gynecology, pain management, physiatry, and if appropriate, behavioral health.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 4","pages":"133-136"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trigeminal Neuralgia and Associated Hydrocephalus: Not a Mere Incidental Finding? A Case Report and Literature Review. 三叉神经痛和相关脑积水：不是偶然发现？1例报告及文献回顾。
Pain medicine case reports Pub Date : 2024-05-01
Segev Gabay, Lottem Bergman, Michal Raz, Jonathan Roth
{"title":"Trigeminal Neuralgia and Associated Hydrocephalus: Not a Mere Incidental Finding? A Case Report and Literature Review.","authors":"Segev Gabay, Lottem Bergman, Michal Raz, Jonathan Roth","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is most commonly related to vascular compression of the trigeminal root entry zone into the brainstem. Secondary causes of compression are much less common. TN as a sole manifestation of hydrocephalus has rarely been reported in the literature.</p><p><strong>Case report: </strong>We describe a young woman with medically resistant TN, who was discovered to have a tectal plate glioma causing secondary obstructive hydrocephalus. In addition, she had an incidental finding of ecchordosis physaliphora. Cerebrospinal fluid diversion by an endoscopic third ventriculostomy resulted in TN resolution.</p><p><strong>Conclusion: </strong>Hydrocephalus is a rare diagnosis to consider as a secondary cause for TN. Since the literature on this is sparse, it can be only suggested that in very select cases, treating the hydrocephalus may also treat the TN. Additional studies and reports are required.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 4","pages":"161-165"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ischiofemoral Impingement, An Atypical Cause of Gluteal Pain: A Case Report. 坐骨股撞击，臀痛的非典型原因：1例报告。
Pain medicine case reports Pub Date : 2024-05-01
Stephen RItter, Yousef Darwish, Tiffany Tsay
{"title":"Ischiofemoral Impingement, An Atypical Cause of Gluteal Pain: A Case Report.","authors":"Stephen RItter, Yousef Darwish, Tiffany Tsay","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This is a case of unilateral gluteal pain in a 54-year-old woman.</p><p><strong>Case report: </strong>The patient presented with a 4-month history of left buttock pain after a traumatic fall. Her pain was exacerbated primarily while sitting. Pelvic x-rays showed bilateral acetabular dysplasia. Magnetic resonance imaging of the left femur without contrast was significant for ischiofemoral impingement (IFI), including compression of the quadratus femoris (QF). The QF space displayed a minimum dimension of 0.7 cm. The patient was scheduled for an ultrasound-guided QF injection, but cancelled the procedure due to symptomatic improvement with supportive care.</p><p><strong>Conclusions: </strong>IFI has become increasingly recognized as an uncommon cause of posterior hip, gluteal, or groin pain. Diagnosis of IFI can be challenging given the broad differential and potential for multiple etiologies of pain. Acetabular dysplasia leads to increased femoral anteversion. Thus, patients with acetabular dysplasia may be vulnerable to the development of IFI.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 4","pages":"147-150"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vacuum Disc Phenomenon Turned Gassy Disc Herniation: A Case Report. 真空盘现象转为气盘突出1例。
Pain medicine case reports Pub Date : 2024-05-01
Esther Benedetti de Marrero, Tho Chi Le, Bradley Jones, Andres Missair, Edmond Benedetti, Alejandra Mayorga
{"title":"Vacuum Disc Phenomenon Turned Gassy Disc Herniation: A Case Report.","authors":"Esther Benedetti de Marrero, Tho Chi Le, Bradley Jones, Andres Missair, Edmond Benedetti, Alejandra Mayorga","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The vacuum phenomenon is a radiologic finding that results from gas accumulation within degenerated discs, joints, or vertebrae. This gas can herniate, causing back pain and/or radiculopathy. Asymptomatic imaging abnormalities can be coincidental and/or non-concordant with clinical presentation therefore warranting close evaluation.</p><p><strong>Case report: </strong>This 45-year-old man, previously diagnosed with lumbar facet arthropathy, returned to the clinic for left-sided axial low back pain. Imaging revealed that a gas filled mass in the right lateral recess was affecting the traversing right L5 and S1 nerve roots. Given the exclusive axial symptoms consistent with lumbar zygapophyseal joint arthropathy, the patient was treated with a repeat L3-4 medial branch and L5 dorsal ramus radiofrequency ablation and experienced subsequent near-complete pain resolution.</p><p><strong>Conclusions: </strong>Careful consideration must be taken when conducting clinical evaluation, imaging, diagnosis, and treatment of patients with low back pain given the significant frequency of abnormal, often nonconcordant, radiological findings.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 4","pages":"143-146"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Botulinum Treatment Induced Dropped Head Syndrome in a Patient With Chronic Migraines and Multiple Sclerosis. 肉毒杆菌治疗引起慢性偏头痛和多发性硬化症患者的垂头综合征。
Pain medicine case reports Pub Date : 2024-05-01
Sameer Narula, Clarke Snodgrass
{"title":"Botulinum Treatment Induced Dropped Head Syndrome in a Patient With Chronic Migraines and Multiple Sclerosis.","authors":"Sameer Narula, Clarke Snodgrass","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic migraine treatment typically is treated medically by use of medications, such as nonsteroidal anti-inflammatory drugs and triptans; however, for a subset of patients, botulinum toxin (or Botox) has effectively been shown to be an alternative medication.</p><p><strong>Case report: </strong>Following Botox administration for chronic headaches, our patient developed unforeseen adverse effects and presented with severe neck stiffness, facial droop, and dysphagia, collectively known as dropped head syndrome, prompting them to seek emergency care. In order to counteract botulinum toxicity, we administered neostigmine, but unexpectedly induced cholinergic toxicity, which led to severe secretions and blurry vision. Glycopyrrolate was administered with responsive resolution of symptoms.</p><p><strong>Conclusions: </strong>This case highlights the complexities of managing adverse reactions to Botox and raises considerations for alternative treatments, such as atropine, or concurrent neostigmine treatment with glycopyrrolate.</p>","PeriodicalId":520525,"journal":{"name":"Pain medicine case reports","volume":"8 4","pages":"157-160"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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