The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Spinal Cord Stimulation in the Treatment of Postherpetic Neuralgia in Patients with Chronic Kidney Disease: A Case Series and Review of the Literature

  • Baek, In-Yeob (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Park, Ju-Yeon (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Kim, Hyae-Jin (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Yoon, Ji-Uk (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Byoen, Gyeong-Jo (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Kim, Kyung-Hoon (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University)
  • Received : 2011.05.04
  • Accepted : 2011.05.18
  • Published : 2011.09.01
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Abstract

Background: Postherpetic neuralgia (PHN) is usually managed pharmacologically. It is not uncommon for patients with chronic kidney disease (CKD) to suffer from PHN. It is difficult to prescribe a sufficient dose of anticonvulsants for intractable pain because of the decreased glomerular filtration rate. If the neural blockade and pulsed radiofrequency ablation provide only short-term amelioration of pain, spinal cord stimulation (SCS) with a low level of evidence may be used only as a last resort. This study was done to evaluate the efficacy of spinal cord stimulation in the treatment of PHN in patients with CKD. Methods: PHN patients with CKD who needed hemo-dialysis who received insufficient relief of pain over a VAS of 8 regardless of the neuropathic medications were eligible for SCS trial. The follow-up period was at least 2 years after permanent implantation. Results: Eleven patients received percutaneous SCS test trial from Jan 2003 to Dec 2007. Four patients had successfully received a permanent SCS implant with their pain being tolerable at a VAS score of less than 3 along with small doses of neuropathic medications. Conclusions: SCS was helpful in managing tolerable pain levels in some PHN patients with CKD along with tolerable neuropathic medications for over 2 years.

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References

  1. Sampathkumar P, Drage LA, Martin DP. Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clin Proc 2009; 84: 274-80. https://doi.org/10.4065/84.3.274
  2. Lee JH, Park SK, Lee DI, Jung JK, Lim HK, Cha YD. Assessment of the quality of postherpetic neuralgia related Korean internet sites. Korean J Pain 2009; 22: 141-5. https://doi.org/10.3344/kjp.2009.22.2.141
  3. Sim WS, Choi JH, Han KR, Kim YC. Treatment of herpes zoster and postherpetic neuralgia. Korean J Pain 2008; 21: 93-105. https://doi.org/10.3344/kjp.2008.21.2.93
  4. Choe H, Han YJ. A clinical study on the treatment of postherpetic neuralgia. J Korean Pain Soc 1990; 3: 131-8.
  5. Kim HK, Kim ST, Jung JW, Keoun JY, Kim IS, Chung KS. Lower level laser therapy on postherpetic neuralgia. J Korean Pain Soc 1992; 5: 258-62.
  6. Lee DI, Kim DO, Kim KS, Kwon MI, Shin KI, Kang WJ. Gabapentin for the treatment of postherpetic neuralgia. J Korean Pain Soc 1999; 12: 188-90.
  7. Lee JH, Kim TY, Ha SH, Kwon YE, Yoon CS. Pulsed radiofrequency lesioning of supraorbital and supratrochlear nerve in postherpetic neuralgia: a report of 2 cases. J Korean Pain Soc 2004; 17: 239-42. https://doi.org/10.3344/jkps.2004.17.2.239
  8. Kim WY, Moon DE, Choi JH, Park CM, Han SM, Kim SH. The effect of spinal cord stimulation in patients with complex regional pain syndrome. Korean J Pain 2006; 19: 152-8. https://doi.org/10.3344/kjp.2006.19.2.152
  9. Kim YJ, Kim MH, Lim SH, Lee JH, Lee KM, Cheong SH, et al. Treatment of tremor and spasticity in failed back surgery syndrome with spinal cord stimulation: a case report. Korean J Pain 2006; 19: 107-10. https://doi.org/10.3344/kjp.2006.19.1.107
  10. Costantini A. Spinal cord stimulation. Minerva Anestesiol 2005; 71: 471-4.
  11. Kim YC, Kim SH, Cho JY, Hong JH. Cervical spinal cord stimulation using an 8 electrode lead in a patient with complex regional pain syndrome type I: a case report. Korean J Pain 2007; 20: 186-9. https://doi.org/10.3344/kjp.2007.20.2.186
  12. Benzon HT, Chekka K, Darnule A, Chung B, Wille O, Malik K. Evidence-based case report: the prevention and management of postherpetic neuralgia with emphasis on interventional procedures. Reg Anesth Pain Med 2009; 34: 514-21. https://doi.org/10.1097/AAP.0b013e3181b137bd
  13. Kumar K, Toth C, Nath RK. Spinal cord stimulation for chronic pain in peripheral neuropathy. Surg Neurol 1996; 46: 363-9. https://doi.org/10.1016/S0090-3019(96)00191-7
  14. Harke H, Gretenkort P, Ladleif HU, Koester P, Rahman S. Spinal cord stimulation in postherpetic neuralgia and in acute herpes zoster pain. Anesth Analg 2002; 94: 694-700. https://doi.org/10.1097/00000539-200203000-00040
  15. Iseki M, Morita Y, Nakamura Y, Ifuku M, Komatsu S. Efficacy of limited-duration spinal cord stimulation for subacute postherpetic neuralgia. Ann Acad Med Singapore 2009; 38: 1004-6.
  16. Meglio M, Cioni B, Prezioso A, Talamonti G. Spinal cord stimulation (SCS) in the treatment of postherpetic pain. Acta Neurochir Suppl (Wien) 1989; 46: 65-6.
  17. Kouroukli I, Neofytos D, Panaretou V, Zompolas V, Papastergiou D, Sanidas G, et al. Peripheral subcutaneous stimulation for the treatment of intractable postherpetic neuralgia: two case reports and literature review. Pain Pract 2009; 9: 225-9. https://doi.org/10.1111/j.1533-2500.2009.00263.x
  18. Upadhyay SP, Rana SP, Mishra S, Bhatnagar S. Successful treatment of an intractable postherpetic neuralgia (PHN) using peripheral nerve field stimulation (PNFS). Am J Hosp Palliat Care 2010; 27: 59-62. https://doi.org/10.1177/1049909109342089
  19. Kim C. Pathophysiology of postherpetic neuralgia. J Korean Pain Soc 2004; 17(Suppl): 13-6. https://doi.org/10.3344/kjp.2004.17.S.S13

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