Assistant Professor and Program Director University of Wisconsin Madison Madison, Wisconsin, United States
Case Diagnosis: A 41 year old female with left superficial peroneal neuropathy after a scald/burn injury in July 2018
Case Description: The patient had failed multiple pharmacologic modalities in treatment of superficial peroneal neuropathy including compounding cream, lidocaine infusions, and duloxetine before some relief with ultrasound guided superficial peroneal nerve block. The patient was maintained on Gabapentin and underwent psychological evaluation prior to trialing a peripheral nerve stimulator. A peripheral stimulator was trialed with short term relief before proceeding with an implantation of a permanent peripheral nerve stimulator. Tolerated temporary peripheral stimulator trial with reduction in pain from 7/10 to 6/10 with “50% improvement”; proceeded with placement of permanent stimulator one month later with further reduction in pain to 3/10 and “70% improvement” at two weeks follow up visit after implantation and reduction in total gabapentin dose.
Discussions: To date, there have been few if any casereports of the use of a peripheral nerve stimulator treating neuropathic pain secondary to burns/thermal injury.
Conclusions: A peripheral nerve stimulator may be an effective treatment for superficial peroneal neuropathy after thermal injury that is refractory to standard treatment.