Stingray Envenomation Resulting in Neuropathy and Complex Regional Pain Syndrome Treated With Peripheral Nerve Stimulation: A Case Report.

Stingray stings frequently result in severe but temporary pain; they can occasionally result in significant complications, including peripheral nerve injuries and complex regional pain syndrome (CRPS). CRPS is characterized by severe, persistent pain and functional impairment, often following a nerve injury. Conservative treatments may be insufficient, necessitating advanced management strategies. A 19-year-old patient presented with radial neuropathy and CRPS following a stingray sting. Despite conservative treatment and orthopedic surgery, the patient's condition progressed, resulting in debilitating pain and functional limitations. The decision was made to place a SPRINT peripheral nerve stimulation (PNS) system (SPR, Cleveland, OH, US). Sixty days of right radial nerve stimulation resulted in a significant reduction in pain, improved function, and enhanced quality of life. The patient experienced sustained pain relief and functional improvement over the follow-up period after removal of the device. While implanted spinal cord stimulators and permanent peripheral nerve stimulators have been used in the management of the pain from complex regional pain syndrome for many years, and this system is likely being used in the treatment of CRPS currently, this report adds to the literature evidence that use of a 60 day temporary PNS system early in the disease course may resolve the condition before it can become chronic. This case highlights the potential of PNS in managing complex pain syndromes and suggests that further research is needed to confirm its broader applicability and long-term benefits.