Cornea · 2016
Electrical Stimulation of the Trigeminal Ganglion and Intrathecal Drug Delivery Systems for the Management of Corneal Neuropathic Pain.
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Sayegh Rony R, Sweet Jennifer A, Miller Jonathan P, Hayek Salim M
Аннотация
PURPOSE: This case study reports on 2 novel neuromodulatory approaches in the management of a particularly recalcitrant case of corneal neuropathic pain.
METHODS: Report of a case
RESULTS: : A 32-year-old woman presented with intractable bilateral dry eye-like symptoms and corneal neuropathic pain after undergoing laser in situ keratomileusis surgery. Extensive ocular and systemic therapies were unsuccessful. Implantation of an electrode for the electrical stimulation of the trigeminal ganglion resulted in complete resolution of symptoms, but pain recurred after lead migration. Implantation of an intrathecal infusion system for fentanyl and bupivacaine delivery at the C1-C2 level resulted in control of her symptoms with excellent pain relief for more than 1 year.
CONCLUSIONS: Electrical stimulation of the trigeminal ganglion and a high cervical intrathecal pain pump can be used in the management of corneal neuropathic pain unresponsive to ocular and systemic approaches.
METHODS: Report of a case
RESULTS: : A 32-year-old woman presented with intractable bilateral dry eye-like symptoms and corneal neuropathic pain after undergoing laser in situ keratomileusis surgery. Extensive ocular and systemic therapies were unsuccessful. Implantation of an electrode for the electrical stimulation of the trigeminal ganglion resulted in complete resolution of symptoms, but pain recurred after lead migration. Implantation of an intrathecal infusion system for fentanyl and bupivacaine delivery at the C1-C2 level resulted in control of her symptoms with excellent pain relief for more than 1 year.
CONCLUSIONS: Electrical stimulation of the trigeminal ganglion and a high cervical intrathecal pain pump can be used in the management of corneal neuropathic pain unresponsive to ocular and systemic approaches.
Предметные рубрики MeSH
AdultAnalgesics, OpioidAnesthetics, LocalBupivacaineCombined Modality TherapyCorneal DiseasesDrug Delivery SystemsDry Eye SyndromesElectric Stimulation TherapyElectrodes, ImplantedEye PainFemaleFentanylHumansInfusions, SpinalKeratomileusis, Laser In SituMicroscopy, ConfocalRecurrenceTrigeminal GanglionTrigeminal Neuralgia