Successful utilization of high frequency spinal cord stimulation for HIV and chemotherapy induced polyneuropathy.

We present a case of a 53-year-old male who presented with functionally limiting bilateral lower extremity neuropathic pain secondary to multiple subtypes of small fiber neuropathy. He had failed management with multiple conservative measures including oral medications, physical therapy and desensitization techniques. He ultimately underwent placement of a spinal cord stimulator and continued to experience 80% improvement of his pain, as well as improved function and quality of life at 5 month follow-up. To our knowledge, this is the first reported case of successful treatment of multiple subtypes of small fiber neuropathy with spinal cord stimulator.

We report a case of a 53-year-old male who presented with multiple subtypes of small fiber neuropathy, characterized by abnormal sensation and nerve pain in his distal lower extremities, which was making performing his activities of daily living challenging. He had failed multiple conservative measures including oral medications, physical therapy and desensitization techniques. The patient then underwent a trial with a spinal cord stimulator, which includes placing a device in the spinal canal that can alleviate pain by providing low levels of electrical current. At the 5 month follow-up, he continued to report 80% improvement of his pain as well as improved function and quality of life. This is the first reported use of spinal cord stimulator in a patient with multiple subtypes of small fiber neuropathy.

Successful application of spinal cord stimulation in a patient with refractory bilateral meralgia paresthetica.

We present a 38-year-old morbidly obese male who presented with functionally limiting bilateral anterior thigh pain consistent with meralgia paresthetica. His symptoms had been unresponsive to conservative measures which included physical therapy, oral medications and multiple nerve blocks. Patient underwent a trial of spinal cord stimulation (SCS), experiencing 70% of pain relief. He then underwent permanent SCS implant. At subsequent follow-ups 3 and 6 months later, he continued to report 70% improvement of his pain, as well as improved function and quality of life. To our knowledge, this is only the second reported case of successful treatment of meralgia paresthetica with SCS, and the first in a morbidly obese patient.

We report a case of a 38-year-old obese male who presented with meralgia paresthetica, a condition characterized by abnormal sensation and nerve pain to the outer aspect of the thigh, limiting his ability to perform activities of daily living. His pain was unresponsive to multiple treatment options such as physical therapy, oral medications and a series of injections with local anesthetic and corticosteroid medications. We then proceeded with spinal cord stimulation, which consists of implanting a device that provides low levels of electrical current to the spinal cord, in hopes of alleviating his pain. After implantation of the device, at 3- and 6-month follow-ups, he was able to achieve 70% improvement of his pain, with the ability to perform his daily activities. This is the second case reported of the use of spinal cord stimulation for this type of condition.