New Onset Tinnitus after High-Frequency Spinal Cord Stimulator Implantation

Abstract

The most common complications of spinal cord stimulation (SCS) therapy are generally related to surgical site infection and hardware malfunction. Less well understood are the adverse neurological effects of this therapy. We present the case of a patient who underwent placement of a Senza HF10 high-frequency spinal cord stimulator with subsequent development of tinnitus, vertigo, intermittent involuntary left facial twitches, and perioral numbness. These symptoms resolved following deactivation of her device. To further explore these less common neurologic complications of SCS therapy, a review of literature and a review of the U.S. Food and Drug Administration Manufacturer and User Facility Device Experience database are included. Further research and investigation in this area are needed so that clinicians and patients may have more complete knowledge and understanding of the potential treatment-limiting complications of spinal cord stimulation.

New-Onset Tinnitus After Dorsal Root Ganglion Stimulator Implantation: A Case Report

“…6 Tinnitus, as a complication, has occurred once in spinal cord stimulation literature. 7 The incorrect neural plasticity leading to chronic pain is similar to tinnitus, 9,[12][13][14] and stimulation of the auditory cortex has been performed by neurosurgeons to treat tinnitus. 8,10 Tonndorf was an early advocate for understanding the physiologic similarities between chronic pain and tinnitus.…”

“…There is 1 reported case of tinnitus after dcSCS implantation. 7 Neurosurgical literature supports auditory cortex stimulation for the treatment of tinnitus, 8 and details a similar mechanism for auditory cortex stimulation as motor cortex stimulation for deafferentiation. 8 According to Dr Bauer, “Aberrant patterns of neural firing, similar to those known to accompany chronic pain, were held to be responsible for the sensation of tinnitus.” 9 Tinnitus can be disabling, leading to sleep deprivation, depression, and cognitive problems.…”

“…Our patient's report of ringing in her ears during her DRG trial was a clue to her eventual tinnitus complication only in hindsight. Given there is only 1 other report of dcSCS neuromodulation leading to tinnitus, 7 this adverse event is exceedingly rare. Her 5 min/45 min cycle of DRG-S use is reasonable, given her continued relief from the DRG-S and the disabling nature of tinnitus.…”

21st century medicine and emerging biotechnological syndromes: a cross- disciplinary systematic review of novel patient presentations in the age of technology

“…Complications of Vagal Nerve Stimulators (VNS) often presented with an aura of throat and respiratory symptoms (52) (53). Failures of spinal cord stimulators presented with varied symptoms and signs, including tinnitus (54) and refractory sexual arousal (55).…”

“…One challenge for practitioners is that biotechnological syndromes manifesting in their specialty, may result from a technology initiated within an unfamiliar domain. For example, (i) Refractory sexual arousal subsequent to a neurostimulator ( 55); (ii) New onset tinnitus following spinal stimulator implantation (54); (iii) Abdominal spasms resulting from pacemaker phrenic nerve stimulation ( 70); (iv) Arm pain secondary to brachial plexus injury caused by impingement from a loop of ICD lead (71).…”