Allergy Considerations in Implanted Neuromodulation Devices

Brown, Austin; Mandelberg, Nataniel; Munoz-Mendoza, Diana; Palys, Viktoras; Schalock, Peter C.; Mogilner, Alon Y.; North, Richard B.; Petersen, Erika

doi:10.1111/ner.13332

Cited by 17 publications

(4 citation statements)

References 80 publications

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“…[4,20] Brown et al conducted a literature review and documented 13 published cases regarding allergic reactions to neuromodulation devices, with local dermatitis, erythema, and pruritus among the most common symptomatologies described. [3] In many cases, a complete replacement of the device to a customized one free of allergen(s) affecting the patient has been necessary to prevent unforeseen inflammatory reactions. [20] us, these customized devices can necessitate the use of materials such as gold.…”

Section: Discussionmentioning

confidence: 99%

Pruritus and urticaria induced by neurostimulation: A case report and review of literature

Goel,

Manjunath,

Kozel

et al. 2023

Surgical Neurology International

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Background: Spinal cord stimulation (SCS) consists of the implantation of neuromodulatory devices in the spinal cord to treat refractory neuropathic pain. Although SCS technology has been proven of immense clinical benefit, complications remain including refractory pain, infection risk, and electrode migration or displacement. Till date, there are minimal reports of allergic side effects following SCS implantation. Case Description: In the first case, a 36-year-old male with chronic axial and radicular neuropathic pain in underwent implantation of an open paddle lead and generator. Within 1–3 h of activating the SCS, he developed diffuse raised erythematous hives. Over time, the SCS had immense clinical benefit for his pain reduction; however, he continued to experience recurrent hives and various other allergic reactions including facial flushing and photosensitivity. Four years later, he ultimately opted to retain the device for its clinical pain benefits. In the second case, a 35-year-old female with acute, intractable bilateral occipital neuralgia and a past medical history of Type 1 Chiari Malformation status-post-posterior fossa decompression underwent implantation of an occipital nerve stimulator (ONS). At 1-month follow-up, she began to experience pruritus across the back of her head and along the subcutaneous course of the lead. At 8 months, she continued to experience persistent symptoms, ultimately opting for device removal. Conclusion: Although allergic reactions to implanted neurostimulation systems are rare, and mechanisms not completely understood, existing studies posit multiple theories surrounding the pathophysiology of allergic reactions to these devices, such as delayed hypersensitivity reactions or contact dermatitis. Further research is needed to elucidate the cutaneous and immunologic side effects of SCS and ONS devices.

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Section: Discussionmentioning

confidence: 99%

Pruritus and urticaria induced by neurostimulation: A case report and review of literature

Goel,

Manjunath,

Kozel

et al. 2023

Surgical Neurology International

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“…Although such complications are meticulously documented, certain adversities related to neuromodulation devices remain less recognized. Allergic reactions, commonly manifesting as localized pruritus and erythema, may be incited by constituents such as titanium, silicone, and polyurethanes [3]. In particular, Brown et al identified only one allergic presentation among 13 DBS recipients, located at the impulse generator site on the chest wall.…”

Section: Dear Editormentioning

confidence: 99%

Deep Brain Stimulation in Advanced Parkinson’s Disease: An Uncommon Case of Allergic Encephalitis

Chen,

2024

JMD

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“…Аллергические реакции являются редкими и малоизученными осложнениями имплантации нейромодуляторных устройств. В настоящее время нет руководств по лечению аллергических реакций на эти устройства и их компоненты [4]. Инфекция имплантата при DBS с поздним началом часто ассоциирована с аллергическими реакциями, особенно в периоде свыше 3 месяцев после операции.…”

Section: цель работыunclassified

Clinical Case of Early Neuroborreliosis in a Female Patient with Generalized Dystonia with Deep Brain Stimulation

Чернуха¹,

Лихачев²,

Ващилин³

et al. 2023

Неврология И Нейрохирургия. Восточная Европа

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В статье приводится описание клинического случая пациентки с сочетанием двух редких диагнозов: нейроборрелиоза и генерализованной дистонии на фоне глубокой стимуляции мозга. Диагностика раннего нейроборрелиоза у пациентки с генерализованной дистонией на фоне глубокой стимуляции мозга была затруднительна из-за стертости клинической симптоматики и необходимости исключения инфекций, обусловленных установкой нейростимулятора. Выполнение широкого спектра обследований, включая анализ на ВИЧ, исследование спинномозговой жидкости, иммуноблот, позволило диагностировать ранний нейроборрелиоз, который клинически проявлялся серозным менингитом и невропатией лицевого нерва с умеренным прозопарезом. Назначение антибиотикотерапии с отсрочкой решения по операции эксплантации системы для глубокой стимуляции мозга позволило сохранить эффект от нейростимуляции, диагностировать ранний нейроборрелиоз и назначить своевременное лечение. На фоне стандартного курса лечения цефтриаксоном наблюдался полный регресс симптомов Лайм-боррелиоза. In the article, we described the clinical case of a female patient with a combination of two rare diagnoses: neuroborreliosis and generalized dystonia with deep brain stimulation. Diagnosis of early neuroborreliosis in the patient with generalized dystonia and deep brain stimulation was difficult. The patient had erased clinical symptoms, and it was necessary to exclude infections caused by the implantation of a neurostimulator. We performed a wide range of examinations, including HIV, analysis of cerebral spinal fluid, immunoblot, allowing us to diagnose early neuroborreliosis, which was clinically manifested by serous meningitis and facial neuropathy with moderate prosoparesis. Administrating antibiotic therapy with a delayed decision on the operation for deep brain stimulation system explantation allowed preserving the effect of neurostimulation, diagnosing early neuroborreliosis and prescribing timely treatment. A complete regression of Lyme borreliosis symptoms was observed against the background of the standard course of ceftriaxone treatment.

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Allergy Considerations in Implanted Neuromodulation Devices

Cited by 17 publications

References 80 publications

Pruritus and urticaria induced by neurostimulation: A case report and review of literature

Pruritus and urticaria induced by neurostimulation: A case report and review of literature

Deep Brain Stimulation in Advanced Parkinson’s Disease: An Uncommon Case of Allergic Encephalitis

Clinical Case of Early Neuroborreliosis in a Female Patient with Generalized Dystonia with Deep Brain Stimulation

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