Using Spinal Cord Stimulators To Manage Central Post-stroke Pain Syndrome; When Multimodal Therapies Fail
67 y.o. F w/ PMHx of HTN, well-managed T2DM, anxiety, and depression suffered from a right MCA stroke with residual left hemiplegia and persistent left-sided “burning” pain in body and face, diagnosed as Central Post-stroke Pain (CPSP) syndrome. The physically debilitating chronic neuropathic pain was refractory to multimodal management with pharmacologic agents (gabapentin, tramadol) and sympathetic nerve blocks (stellate ganglion, lumbar sympathetic). CPSP is challenging to treat and after exhausting alternative treatment options, a spinal cord stimulator (SCS) trial demonstrated significant pain improvement with eventual permanent implant. We discuss the pathophysiology of CPSP, indications, and benefits regarding use of SCS.
Venkatesh N, Lau S, Clemans R. Using spinal cord stimulators to manage central post-stroke pain syndrome; when multimodal therapies fail. Presented at: American Society of Anesthesiology Annual Meeting; 2022 Oct 21-25; New Orleans, LA.
American Society of Anesthesiology Annual Meeting, New Orleans, LA, October 21-25, 2022.