title: Case report: successful epiradicular peripheral nerve stimulation of the C2 dorsal root ganglion for postherpetic neuralgia.
abstract: BACKGROUND
  Postherpetic neuralgia (PHN) is the most common complication following an acute varicella zoster virus infection. PHN often results in a chronic severe pain condition refractory to conservative pain management treatments. Peripheral nerve stimulation over the affected spinal nerve root may be an effective treatment option for patients with intractable PHN.
  
  
  OBJECTIVE
  To describe a successful case of peripheral nerve stimulation of the second cervical dorsal root ganglion for the treatment of intractable PHN.
  
  
  METHODS
  An 80-year-old man with a 15-month history of severe PHN was referred to our clinic for pain management. His pain was localized to the left side in the distribution of the C2 dermatome. The patient's pain was unresponsive to comprehensive conventional treatments for PHN including physical therapy, membrane stabilizing medications, opioids, anti-inflammatories, cervical epidural steroid injections, cervical facet joint injections, and dorsal root ganglion blockade with pulsed radiofrequency. After failing to respond to conservative and interventional therapies, a peripheral nerve stimulator trial was conducted for a period of seven days. The lead was placed within the epidural space over the atlanto-axial joint under fluoroscopy to stimulate the left C2 nerve root. This trial resulted in a significant decrease of the patient's pain, and discontinuation of all pain medications.
  
  
  CONCLUSIONS
  We describe a case of successful electrode placement at the C2 spinal level for the treatment of refractory PHN.
authors: Mayo Clinic College of Medicine, Scottsdale, AZ 85258, USA. lynchmd@gmail.com
authors: Paul J
authors: PJ
authors: Lynch
authors: Tory
authors: T
authors: McJunkin
authors: Eric
authors: E
authors: Eross
authors: Stacie
authors: S
authors: Gooch
authors: Jillian
authors: J
authors: Maloney
mesh_terms: D000369:Aged, 80 and over; D002574:Cervical Vertebrae; D004599:Electric Stimulation Therapy / Q000379:methods*; D004824:Epidural Space; D005727:Ganglia, Spinal / Q000502:physiology*; D006562:Herpes Zoster / Q000150:complications; D006801:Humans; D008297:Male; D051474:Neuralgia, Postherpetic / Q000209:etiology / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D010525:Peripheral Nerves / Q000502:physiology*; D013126:Spinal Nerve Roots / Q000502:physiology*