Department of Anesthesiology, Division of Pain Medicine, Duke University Medical Center, Durham, North Carolina 27705, USA.
Neuromodulation. 2011 Nov-Dec;14(6):539-40; discussion 541. doi: 10.1111/j.1525-1403.2011.00367.x. Epub 2011 Jul 7.
The use of occipital nerve stimulators for the treatment of migraines has recently been suggested. However, there have been reports of complications, including lead migration causing local muscle stimulation and spasm with local burning sensation and loss of successful neuromodulation.
We report a case of a patient who had successful permanent implantation and then presented with suspicion of lead migration. Upon examination of the lead at time of repositioning it was found that the insulation had eroded and the conducting wires exposed at the anchor site.
Disruption of occipital nerve stimulator lead insulation may mimic lead migration with failure of neuromodulation, spasm, and local burning sensations. Prior to reimplanting, a lead should be thoroughly inspected to ensure there is no mechanical failure. Anchoring should be performed with gentle direct suturing or the use of a protective anchoring device.
最近有人提出使用枕神经刺激器来治疗偏头痛。然而，已经有报道称存在并发症，包括导线迁移导致局部肌肉刺激和痉挛，伴有局部烧灼感和成功的神经调节丧失。
我们报告了一例成功进行永久性植入后出现疑似导线迁移的患者。在重新定位导线时，发现其绝缘层已经腐蚀，导线在锚定点暴露。
枕神经刺激器导线绝缘层的破坏可能会导致神经调节失败、痉挛和局部烧灼感，类似于导线迁移。在重新植入之前，应彻底检查导线，确保没有机械故障。锚固应采用轻柔的直接缝合或使用保护性锚固装置。
