Hylands-White Nicholas, Duarte Rui V, Beeson Paul, Mayhew Stephen D, Raphael Jon H
Faculty of Health, Birmingham City University, Birmingham, UK.
Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Room 124, Murray Learning Centre, Birmingham, B15 2TT, UK.
J Clin Monit Comput. 2016 Dec;30(6):845-848. doi: 10.1007/s10877-015-9781-9. Epub 2015 Sep 24.
Pain is a subjective response that limits assessment. The purpose of this case report was to explore how the objectivity of the electroencephalographic response to thermal stimuli would be affected by concurrent spinal cord stimulation. A patient had been implanted with a spinal cord stimulator for the management of complex regional pain syndrome of both hands for 8 years. Following ethical approval and written informed consent we induced thermal stimuli using the Medoc PATHWAY Pain & Sensory Evaluation System on the right hand of the patient with the spinal cord stimulator switched off and with the spinal cord stimulator switched on. The patient reported a clinically significant reduction in thermal induced pain using the numerical rating scale (71.4 % reduction) with spinal cord stimulator switched on. Analysis of electroencephalogram recordings indicated the occurrence of contact heat evoked potentials (N2-P2) with spinal cord stimulator off, but not with spinal cord stimulator on. This case report suggests that thermal pain can be reduced in complex regional pain syndrome patients with the use of spinal cord stimulation and offers objective validation of the reported outcomes with this treatment.
疼痛是一种限制评估的主观反应。本病例报告的目的是探讨脊髓刺激同时进行时，热刺激的脑电图反应的客观性会受到怎样的影响。一名患者植入脊髓刺激器以治疗双手复杂性区域疼痛综合征已8年。在获得伦理批准和书面知情同意后，我们使用Medoc PATHWAY疼痛与感觉评估系统对患者的右手进行热刺激，分别在关闭脊髓刺激器和开启脊髓刺激器的情况下进行。患者报告称，开启脊髓刺激器时，使用数字评分量表测得热诱导疼痛有临床显著减轻（减轻了71.4%）。脑电图记录分析表明，关闭脊髓刺激器时出现接触热诱发电位（N2 - P2），而开启脊髓刺激器时未出现。本病例报告表明，脊髓刺激可减轻复杂性区域疼痛综合征患者的热痛，并为该治疗所报告的结果提供了客观验证。
