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Peripheral Neuromodulation for Central Pain: A Case of Thalamic Pain Syndrome Managed With Percutaneous Nerve
Rohan Gogoi1, Maximos Bogdady2, Min Ju Kim3
1Montefiore Medical Center, Bronx, NY.
Background:
Thalamic pain syndrome is a debilitating neuropathic condition that may develop after a thalamic stroke. Patients experience diffuse whole-body pain, contralateral to their stroke, that is often refractory to standard therapies.
Case Report:
A 53-year-old woman with a history of right basal ganglia and thalamic hemorrhagic stroke presented with 10 years of severe, left-sided pain unresponsive to antispasmodics, anticonvulsants, and nonsteroidal anti-inflammatory drugs. A diagnostic sciatic nerve block provided temporary relief, prompting placement of a percutaneous peripheral nerve stimulator (PNS) of the sciatic nerve using the SPRINT system. The patient reported approximately 50% pain reduction throughout the patient's left calf, foot, and ankle during treatment, which persisted after lead explantation.
Conclusions:
This case suggests that percutaneous may offer sustained pain relief for thalamic pain syndrome refractory to conventional management. Further research is needed to clarify its mechanism and long-term efficacy in central neuropathic pain.
