Peripheral Nerve Stimulation for the Treatment of Lower Extremity Peripheral Neuropathy in a Diabetic Amputee Case Report.

BACKGROUND

Providing adequate analgesia for peripheral neuropathy in poorly controlled diabetics remains challenging, and effective invasive therapy increases the risk of infection and delayed wound healing. A peripheral nerve stimulator (PNS) is a beneficial treatment option for neuropathy. This case is IRB exempt from obtaining informed consent for publication. The report is de-identified in accordance with the Safe Harbor method. All 18 individual identifiers are removed, and there is no evidence to suggest that the information could be used alone or in combination with other information to identify the patient.

CASE REPORT: A 29-year-old woman with a medical history of poorly controlled type-1 diabetes mellitus, despite multiple medications, presented to an outpatient clinic with left lower extremity neuropathic pain following a right below-knee amputation (BKA) secondary to sustaining a nonhealing right foot wound. The patient underwent a PNS trial for 4 days, which resulted in a decrease in her pain level by more than half. A left lower extremity wirelessly powered permanent PNS device was placed, which resulted in improved sleep, ability to walk longer distances, and an 88% reduction in pain.

CONCLUSIONS

PNS was safe and successful for left lower extremity neuropathy in a patient with poorly controlled diabetes and a right BKA.