Short-term spinal cord stimulation for refractory Elsberg syndrome in diabetic neuropathy: A case report

Elsberg syndrome is a type of postinfectious lumbosacral radiculitis typically triggered by neurotropic viruses and manifests as bladder/bowel dysfunction, saddle sensory disturbances (including hypoesthesia, hyperesthesia, or dysesthesia), and variable neurological deficits. Typically self-limiting, it often responds to antiviral and neurotropic therapies. However, in patients with comorbidities that confer susceptibility to peripheral neuropathy (e.g., diabetes mellitus), timely escalation to neuromodulation strategies, such as spinal cord stimulation, may be warranted to optimize functional outcomes when conservative measures are inadequate.

A 60-year-old male with diabetes mellitus presented with severe bladder and bowel dysfunction persisting for more than two months, followed by left gluteal and perianal (saddle area) herpes zoster eruption that was accompanied by significant neuropathic pain. Following a suboptimal response to conservative therapy, the patient underwent implantation of a short-term spinal cord stimulation. Following a 10-day trial of continuous tonic stimulation, the percutaneous electrode lead was removed. The patients experienced no surgical complications, and after the procedure, the patient achieved complete restoration of bladder and bowel function and significant pain alleviation. Two-month follow-up confirmed sustained full recovery.

Early implementation of short-term spinal cord stimulation represents a promising therapeutic approach for promoting neurological recovery in patients with Elsberg syndrome refractory to conservative management, especially those with predisposing comorbidities such as diabetes mellitus.