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Refractory neuropathic pain from a median nerve injury: spinal cord or peripheral nerve stimulation? A case report

  • Q. DewandreEmail author
  • A. Dubuisson
  • B. Kaschten
  • G. Reuter
  • D. Martin
Original article
  • 14 Downloads

Abstract

Spinal cord stimulation (SCS) is the most frequently used neuromodulation technique even for neurogenic pain from a peripheral nerve injury although peripheral nerve stimulation (PNS) has been designed for this purpose. PNS appears less invasive than SCS or deep brain stimulation. It provides greater and specific target coverage and it could be more cost-effective than SCS because low electrical stimulation is exclusively delivered to the precise painful territory. We report a case of excellent result following median nerve stimulation at arm level after SCS failure and a 10-year history of intense pain. PNS would certainly have been considered much earlier if it was accepted and reimbursed by the Belgium National Insurance. PNS is a safe, simple, and efficient technique available for decades but it is still considered as experimental and underemployed. Belgian National Insurance fears an explosion of indications on neuromodulation if PNS was reimbursed. We consider that PNS aside SCS and other neuromodulation techniques should be made available in Belgium in case of peripheral chronic neuropathic pain.

Keywords

Peripheral nerve stimulation Spinal cord stimulation Neuromodulation Neuropathic pain Neurogenic pain 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the unique participant.

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Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.Neurosurgery DepartmentCHU LiègeLiègeBelgium

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