单导联经皮外周神经刺激治疗偏瘫性肩痛

Previous studies demonstrated the efficacy of 6weeks of a 4-lead percutaneous, peripheral nerve stimulation system in reducing hemiplegic shoulder pain. This case report describes the first stroke survivor treated for 3weeks with a less complex, single-lead approach. The participant was a 59-year-old male who developed hemiplegic shoulder pain shortly after his stroke 7.5years prior to study enrollment and was treated with multiple modalities without sustained pain relief. After study enrollment, a single intramuscular lead was placed percutaneously into the deltoid muscle. He was treated 6 hours per day for 3weeks and the lead was removed. The primary outcome measure was the Brief Pain Inventory (Short-Form) Question 3 (BPI-3), which queries the worst pain in the last week on a 0 to 10 numeric rating scale. At baseline, BPI 3 was an 8. At the end of treatment and at 1 and 4weeks after treatment was completed, BPI 3 scores were 3, 2, and 2, respectively. Substantial improvements in quality of life measures were also observed. The participant remained infection-free and the lead was removed fully intact. After completing the study protocol, the participant was followed clinically for 13months posttreatment with complete resolution of hemiplegic shoulder pain. This case report demonstrates the feasibility of a single-lead peripheral nerve stimulation for the treatment of chronic hemiplegic shoulder pain. Additional studies are needed to further demonstrate safety and efficacy, determine optimal dose, define optimal prescriptive parameters, expand clinical indications, and demonstrate long-term effect.