Long term clinical outcome of peripheral nerve stimulation in patients with chronic peripheral neuropathic pain☆

Abstract 

Background

Chronic neuropathic pain after injury to a peripheral nerve is known to be resistant to treatment. Peripheral nerve stimulation is one of the possible treatment options, which is, however, not performed frequently. In recent years we have witnessed a renewed interest for PNS. The aim of the present study was to evaluate the long-term clinical efficacy of PNS in a group of patients with peripheral neuropathic pain treated with PNS since the 1980s.

Methods

Of an original series of 11 patients, 5 patients could be invited for clinical examination, detailed assessment of clinical pain and QST examination. The assessments were done both during habitual use of PNS and with the stimulator off.

Results

Average pain intensity and pain unpleasantness ratings as assessed with visual analog and verbal rating scales showed significant beneficial effects of PNS. Quality of life measures (sleep and daily functioning) also showed positive effects. Quantitative Sensory Testing results did not show significant differences in cold pain and heat pain thresholds between the “ON” and “OFF” conditions.

Conclusion

In selected patients with peripheral neuropathic pain PNS remains effective even after more than 20 years.

Abbreviations: DCS, dorsal column stimulation, PNS, peripheral nerve stimulation, QST, Quantitative Sensory Testing, VAS, visual analog scales

Keywords: Pain, Peripheral nerve stimulation, Chronic neuropathic pain, Quantitative Sensory Testing