title: Fully implantable peripheral nerve stimulation for the treatment of hemiplegic shoulder pain: a case report.
abstract: This case report describes the first participant treated with a fully implantable, single-lead peripheral nerve stimulation system for refractory hemiplegic shoulder pain. During the 6-wk trial stage, a temporary lead was placed percutaneously near the terminal branches of the axillary nerve to the deltoid. The primary outcome measure was the Brief Pain Inventory-Short Form Question 3, a 0-10 pain numeric rating scale. The participant experienced 75% pain reduction and proceeded to the implantation stage, where he received a single-lead, implantable pulse generator. After 3 wks, the participant became pain-free. However, 7 wks after implantation, the system was turned off because of an unrelated acute medical illness. Hemiplegic shoulder pain reemerged with a Brief Pain Inventory-Short Form Question 3 score of 9. After 11 wks of recovery, peripheral nerve stimulation was reinitiated and the participant became pain-free through the 9-mo follow-up. At 12 mos, Brief Pain Inventory-Short Form Question 3 score was 1. This case report demonstrates the feasibility of a single-lead, fully implantable peripheral nerve stimulation system for refractory hemiplegic shoulder pain.
authors.affiliation: From the Department of Physical Medicine and Rehabilitation (VQCN, CCG, MW) and Department of Cardiology (WCB), Carolinas Medical Center, Charlotte, North Carolina; SPR Therapeutics, LLC, Cleveland, Ohio (MEB, TEL, KWS); NDI Medical, LLC, Cleveland, Ohio (RS, JHG); Department of Physical Medicine and Rehabilitation, Department of Biomedical Engineering, and the Cleveland Functional Electrical Stimulation Center, Case Western Reserve University, Cleveland, Ohio (JC); and Department of Physical Medicine and Rehabilitation, MetroHealth Rehabilitation Institute of Ohio, Cleveland, Ohio (JC).
authors.forename: Vu Q C
authors.initials: VQ
authors.lastname: Nguyen
authors.forename: William C
authors.initials: WC
authors.lastname: Bock
authors.forename: Christine C
authors.initials: CC
authors.lastname: Groves
authors.forename: Marybeth
authors.initials: M
authors.lastname: Whitney
authors.forename: Maria E
authors.initials: ME
authors.lastname: Bennett
authors.forename: Tina E
authors.initials: TE
authors.lastname: Lechman
authors.forename: Robert
authors.initials: R
authors.lastname: Strother
authors.forename: Julie H
authors.initials: JH
authors.lastname: Grill
authors.forename: Kathryn W
authors.initials: KW
authors.lastname: Stager
authors.forename: John
authors.initials: J
authors.lastname: Chae
mesh_terms: D000368:Aged; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D058542:Implantable Neurostimulators; D008297:Male; D010148:Intractable Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D020069:Shoulder Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation / Q000295:instrumentation*