Peripheral subcutaneous stimulation for the treatment of intractable postherpetic neuralgia: two case reports and literature review.
Postherpetic neuralgia (PHN) is a common cause of chronic pain in the elderly. Antidepressants, anticonvulsants, and opioids may reduce discomfort in many patients, while others have pain intractable to all forms of therapy. We present a novel treatment approach for intractable PHN utilizing percutaneous peripheral nerve stimulation. Two cases are described in which an 80-year-old man and a 67-year-old woman with intractable PHN, lasting 2 and 10 years, respectively, were effectively treated with implantation of two octapolar leads in the lateral thoracic region. These cases suggest that peripheral nerve stimulation may offer an alternative treatment option for intractable pain associated with PHN especially in the elderly where treatment options are limited because of existing comorbidities.
Kouroukli
Irene
I
Department of Anaesthesiology and Pain Clinic, Hippocratio General Hospital, Athens, Greece. irenekouroukli@hotmail.com
Neofytos
Dionissios
D
Panaretou
Venetiana
V
Zompolas
Vassilios
V
Papastergiou
Dimitrios
D
Sanidas
Georgios
G
Papavassilopoulou
Theonymfi
T
Georgiou
Loukas
L
D000344:Afferent Pathways / Q000503:physiopathology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004599:Electric Stimulation Therapy / Q000379:methods*; D004566:Electrodes / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D051474:Neuralgia, Postherpetic / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D010148:Intractable Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010525:Peripheral Nerves / Q000503:physiopathology*; D011984:Sensory Receptor Cells / Q000502:physiology*; D012867:Skin / Q000294:innervation / Q000503:physiopathology; D013127:Spinal Nerves / Q000503:physiopathology; D013909:Thorax / Q000294:innervation / Q000503:physiopathology; D016896:Treatment Outcome