Presented at the 2013 AAPM Annual Meeting « Back

Complex Regional Pain Syndrome, Type I, Treated by Suprascapular Nerve Peripheral Field Stimulation

Monika A. Krzyzek, DO, monika.krzyzek@us.army.mil¹, Robert H. Overbaugh, MD², Duane E. Griffin, OPA MPH MPAS², Kevin Guthmiller, MD², Karl A. Lautenschlager, MD¹, Brandon J. Goff, DO³, Prasad Lakshminarasimhiah, MD¹, (1) San Antonio Military Medical Center, San Antonio, Texas, (2) Brooke Army Medical Center, Fort Sam Houston, Texas, (3) San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, Texas

Introduction/Statement of the Problem: We present a novel application of peripheral field stimulation for upper extremity Complex Regional Pain Syndrome (CRPS). This 45 year-old gentleman was diagnosed with left upper extremity CRPS, Type I, subsequent to a left wrist hyperextension injury years prior to presentation. He described dysesthesias, hyperpathia, and allodynia from left wrist to shoulder and constant burning and stabbing pain of 8-9 intensity. He experienced swelling, chronic hyperhidrosis, color fluctuations, decreased hair growth and nail changes. Complicating his pain were ongoing attacks of gout. He previously failed neuropathic medications and a left stellate ganglion block (noticeable but minimal relief). Following this, he underwent left suprascapular nerve block with 100% relief for almost two days, thus the patient chose to undergo a trial of peripheral field stimulation over the left suprascapular nerve with 100% relief during the trial. Materials and Methods: Eight contact Octrode lead (St. Jude) was implanted over the supraspinatus muscle with good stimulation of the suprascapular nerve and powered by an implanted Eon Mini pulse generator (St. Jude). Results: Surgical implantation of the peripheral field stimulation system over the left suprascapular nerve was successful and the patient reported 100% pain relief, allowing him to use the left upper extremity with minimal functional restrictions. Conclusions: In our practice, this is the second successful treatment of CRPS, Type I, using peripheral field stimulation over the suprascapular nerve. We hope for continued positive results. We share this treatment option for refractory upper extremity CRPS, Type I.

Funding: None

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