Multimodal therapeutic assessment of peripheral nerve stimulation in neuropathic pain: five case reports with a 20-year follow-up

European Journal of Pain : EJP
Ron KupersLeon Plaghki

Abstract

Neuropathic pain following peripheral nerve lesion is highly resistant to conventional pain treatments but may respond well to direct electrical peripheral nerve stimulation (PNS). In the 1980s, we treated a series of 11 peripheral neuropathic pain patients with PNS. A first outcome assessment, conducted after a 52-month follow-up, revealed that the majority of the patients were significantly improved. Here, we present the results of a second and more comprehensive follow-up, conducted after more than 20years of PNS usage. Of the six patients still using PNS, five participated in a multimodality assessment of the long-term efficacy of PNS. Home evaluations showed reduced pain ratings and improved quality-of-life during active periods of stimulation. Quantitative sensory testing confirmed the neuropathic character of the pain complaints. PNS had no significant overall effect on tactile detection, cool, warmth, cold pain and heat pain thresholds. Laser-evoked potentials showed an enlarged N2-P2 complex during active PNS. Positron Emission Tomography revealed that PNS decreased activation in the pain matrix at rest and during thermal stimulation. PNS led to increased blood flow not only in primary somatosensory cortex, but also in...Continue Reading

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Citations

Nov 28, 2015·Hand Clinics·Jason E PopeTimothy Deer
Oct 14, 2014·Neuromodulation : Journal of the International Neuromodulation Society·Selina JohnsonAndreas Goebel
Aug 18, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Tiffany LinAmitabh Gulati
May 12, 2021·Current Pain and Headache Reports·Natalie H StrandJillian Maloney

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