Deafferentation pain syndromes developing after peripheral nerve lesions are difficult
to treat. According to the follow-up (mean: 39.5 months) of 6 patients suffering from
causalgic pain we will present our method of augmentative therapy in chronic neuropathic
pain caused by peripheral nerve lesions, i. e., peripheral nerve stimulation (PNS),
spinal cord stimulation (SCS) and chronic intrathecal opioid infusion. None of the
patients showed intraoperative or follow-up complications. Evaluated by visual analogue
scales all patients reported a good to excellent pain relief (75 - 100 %). (1) Regarding
the favourable long-term results of PNS, this method should be considered in cases
of mono-neuropathic pain syndromes. (2) Neuropathic pain syndromes which are not assignable
to a singular nerve lesion, can often be managed effectively by SCS. (3) In contrast
to the widespread opinion, deafferentation pain syndromes of central or peripheral
origin can be treated satisfactorly by intrathecal opiate administration.
Key words:
Peripheral nerve stimulation - Spinal cord stimulation - Intrathecal morphine - Peripheral
nerve lesion - Deafferentation pain
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Corresponding Author
Dr. Heinrich Ebel
Neurochirurgische Klinik Universität zu Köln
Joseph-Smann-Straße 9
50924 Köln
Germany
Phone: + 49-2 21-4 78-45 57
Fax: + 49-2 21-4 78-59 21