Abstract:
BACKGROUND:Trigeminal ganglion stimulation can be effective for trigeminal neuralgia. For patients who respond well to neurostimulation delivered percutaneously through the foramen ovale but require extensive revision and removal of instrumentation, a subtemporal approach for stimulation of the trigeminal ganglion is an alternative option as a salvage procedure. CASE DESCRIPTION:We report on a 47-year-old woman who responded well to neurostimulation for trigeminal neuropathic pain over a 1-year period from 2008 to 2009. Her preoperative pain on the numerical rating scale (NRS) was between 7 and 8 out of 10, which decreased to 2 out of 10 postoperatively. However, she developed lead migration because of a motor vehicle accident. After revision surgeries to correct this, she continued to experience pain relief until 2011. At follow-up, signs of infection prompted removal of instrumentation and subsequent return of her pain. She continued to experience persistent and severe pain (NRS score 7 of 10), which was intractable to pharmacologic treatment over 5 years. She returned in 2016 to discuss neurosurgical options, and the original approach was ruled out because of her history of lead migration, erosion, and scarring. A subtemporal approach was pursued as a salvage option, which provided several advantages for this patient. CONCLUSIONS:The subtemporal approach for salvage placement of the trigeminal ganglion stimulating electrode was effective in this patient and minimized risks given her history of erosion and multiple operations. This suggests that the subtemporal approach is a viable salvage operation for trigeminal ganglion stimulation for trigeminal neuropathic pain.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Keifer OP Jr,Zeising K,Tora MS,Campbell M,Bezchlibnyk YB,Boulis Ndoi
10.1016/j.wneu.2018.11.034subject
Has Abstractpub_date
2019-02-01 00:00:00pages
308-310eissn
1878-8750issn
1878-8769pii
S1878-8750(18)32581-6journal_volume
122pub_type
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pub_type: 传,历史文章,杂志文章
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更新日期:2013-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
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