High‐Frequency Supraorbital Nerve Stimulation With a Novel Wireless Minimally Invasive Device for Post‐Traumatic Neuralgia: A Case Report. Issue 4 (6th February 2019)

• Record Type: Journal Article
• Authors: Van Buyten, Jean‐Pierre; Smet, Iris; Devos, Marieke; Vanquathem, Niek E.
• Is Part Of: Pain practice. Volume 19:Issue 4(2019)
• Page Start: 435
• Page End: 439
• Publication Date: 2019-02-06
• Subjects: wireless -- neuromodulation -- supraorbital neuralgia -- post‐traumatic headache -- peripheral nerve stimulation; Pain -- Treatment -- Periodicals; 616.0472
• DOI: 10.1111/papr.12747
• Languages: English
• ISSNs: 1530-7085

Abstract

Abstract: Background: Post‐traumatic neuropathic pain in the head and face is a condition that is often refractory to medical management. Peripheral nerve stimulation (PNS) can be an effective treatment. Successful implantation of a novel minimally invasive wireless device is reported here. Objective: To assess analgesic effects of a minimally invasive wireless PNS device in the treatment of post‐traumatic supraorbital neuralgia (SON). Case Summary: The patient presented with SON following multiple post‐traumatic cranioplasty surgeries, which were complicated by infections. Medical and interventional management failed, and the patient reported a numeric rating scale (NRS) pain score of 8 out of 10. Two octopolar implantable neural stimulators (INSs) (StimRelieve LLC, Pompano Beach, FL, U.S.A.) were implanted with a minimally invasive, percutaneous technique to stimulate the supraorbital nerves. Stimulation parameters were set at a frequency of 10 kHz and a pulse width of 30 microseconds. Results: At 12‐ and 24‐month follow‐up evaluations, the patient's NRS score was only 2 out of 10, and the patient occasionally required 1 g of paracetamol to control the pain. Stimulation was reported to be paresthesia free. There were no adverse events related to the procedure or the treatment until today. Conclusions: High‐frequency stimulation with an external pulse generator and minimally invasive, percutaneous, and bilateral placement of 2 passive INSs on the supraorbital nerves resulted in a significant pain relief in this patient with post‐traumatic SON. The device was safe and effective, and the cosmesis was satisfactory.