Peripheral Neuromodulation for Central Pain: A Case of Thalamic Pain Syndrome Managed With Percutaneous Nerve Stimulation.

BACKGROUND

Thalamic pain syndrome is a debilitating neuropathic condition that may develop after a thalamic stroke. Patients experience diffuse whole-body pain, contralateral to their stroke, that is often refractory to standard therapies.

CASE REPORT: A 53-year-old woman with a history of right basal ganglia and thalamic hemorrhagic stroke presented with 10 years of severe, left-sided pain unresponsive to antispasmodics, anticonvulsants, and nonsteroidal anti-inflammatory drugs. A diagnostic sciatic nerve block provided temporary relief, prompting placement of a percutaneous peripheral nerve stimulator (PNS) of the sciatic nerve using the SPRINT system. The patient reported approximately 50% pain reduction throughout the patient's left calf, foot, and ankle during treatment, which persisted after lead explantation.

CONCLUSIONS

This case suggests that percutaneous may offer sustained pain relief for thalamic pain syndrome refractory to conventional management. Further research is needed to clarify its mechanism and long-term efficacy in central neuropathic pain.