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Median Nerve Stimulation in a Patient with Complex Regional Pain Syndrome Type II
Journal of Korean Neurosurgical Society, 10/23/09
Jeon I–C et al. – A 54–year–old man experienced injury to the second finger of his left hand due to damage from a paintball gun shot 8 years prior, and the metacarpo–phalangeal joint was amputated. He gradually developed mechanical allodynia and burning pain, and there were trophic changes of the thenar muscle and he reported coldness on his left hand and forearm. A neuroma was found on the left second common digital nerve and was removed, but his symptoms continued despite various conservative treatments including a morphine infusion pump on his left arm. The authors therefore attempted median nerve stimulation to treat the chronic pain. The procedure was performed in two stages. The first procedure involved exposure of the median nerve on the mid–humerus level and placing of the electrode. The trial stimulation lasted for 7 days and the patient's symptoms improved. The second procedure involved implantation of a pulse generator on the left subclavian area. The mechanical allodynia and pain relief score, based on the visual analogue scale, decreased from 9 before surgery to 4 after surgery.
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