title: Peripheral median nerve stimulation for the treatment of iatrogenic complex regional pain syndrome (CRPS) type II after carpal tunnel surgery.
abstract: We report on the use and follow-up of direct peripheral nerve stimulation of the median nerve for the treatment of iatrogenic complex regional pain syndrome (CRPS). A 56-year-old woman presented with CRPS type II in the right forearm and hand, which had started after multiple carpal tunnel surgeries and had lasted for 2 years. The visual analogue scale (VAS) score was 8-10 out of 10. After a successful 15-day trial of median nerve peripheral nerve stimulation via a quadripolar lead in the right carpal tunnel space, an implantable pulse generator was inserted in the right infraclavicular space. The VAS score decreased to 1-2 out of 10 and the patient regained the ability to sleep. After 36 months of follow-up, the patient was still experiencing good pain relief without other treatment. We conclude that peripheral nerve stimulation is easy to use in pain management and could offer a valid treatment option for iatrogenic CRPS type II.
authors.affiliation: Neurosurgery, Department of Neurological Sciences, Second University of Naples, c/o Ospedale CTO, Viale Colli Aminei, 21 80131 Naples, Italy. peppemirone@fastwebnet.it
authors.forename: G
authors.initials: G
authors.lastname: Mirone
authors.forename: M
authors.initials: M
authors.lastname: Natale
authors.forename: M
authors.initials: M
authors.lastname: Rotondo
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D002422:Causalgia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008475:Median Nerve / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010147:Pain Measurement; D016896:Treatment Outcome