AUTHOR=Zhao Lin , Song Tao 

TITLE=Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.713366

DOI=10.3389/fneur.2021.713366

ISSN=1664-2295

ABSTRACT=Objective: We aimed to report on the use of short-term high cervical spinal cord stimulation (SCS) combined with peripheral nerve stimulation (PNS) to successfully treat trigeminal postherpetic neuralgia (TPHN) at the V2 and V3 division. We also sought to use a novel form of PNS approach on the maxillary nerve next to the external opening of the foramen rotundum (FR) to treat TPHN at the V2 division.
Method: Two elder patients successfully treated with different neuromodulation methods for TPHN are presented in this case series. A comprehensive literature review of TPHN cases treated with pulsed radiofrequency (PRF), high cervical SCS, and PNS was also performed.
Results: The first case included an 83-year-old female patient with V2 and V3 TPHN who experienced significant pain relief using a combination of short-term high cervical SCS at the C1-C2 level and PNS on the infraorbital nerve (ION). Case 2 was a 68-year-old male patient with V1 and V2 TPHN that received excellent pain relief using short-term PNS on the supraorbital nerve (SON) and the maxillary nerve. Both reported improved quality of life and an enhanced ability to perform daily tasks during a 3-month follow-up period.
Conclusions: Short-term high cervical SCS at the C1-C2 spinal segments to treat V3 TPHN is a feasible and safe method to earlier studies that proved to have an initial efficacy in elder patients. Additionally, by placing the stimulation lead next to the external FR opening, we demonstrated a novel form of PNS on the maxillary nerve not previously reported for TPHN therapy.