Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

Abstract

Objective: We aimed to report on the use of short-term high cervical spinal cord stimulation (SCS) combined with peripheral nerve stimulation (PNS) to successfully treat trigeminal postherpetic neuralgia (TPHN) affecting the V2 and V3 divisions. We also sought to use a novel PNS approach to the maxillary nerve next to the external opening of the foramen rotundum (FR) to treat TPHN at the V2 division.Method: Two elderly patients successfully treated with different neuromodulation methods for TPHN are presented in this case series.Results: The first case referred to an 83-year-old Chinese female patient with V2 and V3 TPHN who experienced a significant pain relief using a combination of short-term high cervical SCS at the C1–C2 level and PNS on the infraorbital nerve (ION). Case 2 was a 68-year-old Chinese male patient with V1 and V2 TPHN that obtained an excellent pain relief after having received short-term PNS on the supraorbital nerve (SON), the supratrochlear nerve (STN), and the maxillary nerve. Both reported improvements in their quality of life and ability to perform daily tasks during a 3-month follow-up period.Conclusions: Short-term high cervical SCS at the C1–C2 spinal segments may be a feasible method to treat recent-onset V3 TPHN in elderly patients. Additionally, by placing the stimulation lead next to the external FR opening, we demonstrated a novel PNS approach to the maxillary nerve not previously reported for TPHN therapy.

Effects of short-term spinal cord stimulation on patients with prolonged disorder of consciousness: A pilot study

“…More broadly, the treatment of spinal cord stimulation includes SCS and st-SCS whose electrodes are placed percutaneously to the spinal epidural for 2 weeks. st-SCS was firstly used clinically to ease pain (16,17), and it also used as experimental treatment to test for response of patients with pain to SCS. If there is significant analgesia, electrodes of SCS will be permanently implanted a few weeks later to maintain control of pain symptoms (18).…”

Clinical effect of short-term spinal cord stimulation in the treatment of patients with primary brainstem hemorrhage-induced disorders of consciousness

“…Short-term spinal cord stimulation (St-SCS) was first used for pain relief and has become an indispensable treatment means for patients with early-stage pain (39)(40)(41). In recent years, with more extensive st-SCS investigations, it has been used in the recovery of consciousness.…”

A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report

“…1 In most cases, single mode of neuromodulation is applied to seek pain relief; recently, emerging evidence has demonstrated that combination of distinct pattern of modulatory strategy can provide satisfactory control of neuropathic pain. [4][5][6] Here, we present a case of severe lower limb pain caused by postherpetic neuralgia. A new dual function DRG stimulator was implanted to provide DRG electrical stimulation and pulsed radiofrequency neuromodulation.…”

“… 1 In most cases, single mode of neuromodulation is applied to seek pain relief; recently, emerging evidence has demonstrated that combination of distinct pattern of modulatory strategy can provide satisfactory control of neuropathic pain. 4 – 6 …”