Van Calenbergh Frank, Gybels Jan, Van Laere Koen, Dupont Patrick, Plaghki Leon, Depreitere Bart, Kupers Ron
Department of Neurosurgery, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, B-3000 Leuven, Belgium.
Surg Neurol. 2009 Oct;72(4):330-5; discussion 335. doi: 10.1016/j.surneu.2009.03.006. Epub 2009 Aug 7.
Chronic neuropathic pain after injury to a peripheral nerve is known to be resistant to treatment. Peripheral nerve stimulation is one of the possible treatment options, which is, however, not performed frequently. In recent years we have witnessed a renewed interest for PNS. The aim of the present study was to evaluate the long-term clinical efficacy of PNS in a group of patients with peripheral neuropathic pain treated with PNS since the 1980s.
Of an original series of 11 patients, 5 patients could be invited for clinical examination, detailed assessment of clinical pain and QST examination. The assessments were done both during habitual use of PNS and with the stimulator off.
Average pain intensity and pain unpleasantness ratings as assessed with visual analog and verbal rating scales showed significant beneficial effects of PNS. Quality of life measures (sleep and daily functioning) also showed positive effects. Quantitative Sensory Testing results did not show significant differences in cold pain and heat pain thresholds between the "ON" and "OFF" conditions.
In selected patients with peripheral neuropathic pain PNS remains effective even after more than 20 years.
已知外周神经损伤后的慢性神经性疼痛难以治疗。外周神经刺激是可能的治疗选择之一,然而,这种治疗并不常用。近年来,我们看到了对外周神经刺激(PNS)重新产生的兴趣。本研究的目的是评估自20世纪80年代以来接受PNS治疗的一组外周神经性疼痛患者中PNS的长期临床疗效。
在最初的11例患者系列中,5例患者可被邀请进行临床检查、详细的临床疼痛评估和QST检查。评估在PNS习惯性使用期间和刺激器关闭时进行。
用视觉模拟和言语评定量表评估的平均疼痛强度和疼痛不愉快程度评分显示PNS有显著的有益效果。生活质量指标(睡眠和日常功能)也显示出积极效果。定量感觉测试结果在“开”和“关”状态下的冷痛和热痛阈值方面未显示出显著差异。
在选定的外周神经性疼痛患者中,即使经过20多年,PNS仍然有效。