REVIEW

Spinal Cord Stimulation for Postherpetic Neuralgia and Parkinson’s Disease: literature review

Estimulação da Medula Espinhal para Neuralgia Pós-Herpética e Doença de Parkinson: revisão da literatura

  • Rafael Caiado Vencio 1    Rafael Caiado Vencio 1
  • Pedro Henrique Araújo Duque 2    Pedro Henrique Araújo Duque 2
  • Carolina Bussab 2    Carolina Bussab 2
  • Paulo Roberto Franceschini 3    Paulo Roberto Franceschini 3
  • Paulo Henrique Pires de Aguiar 4,5,6    Paulo Henrique Pires de Aguiar 4,5,6
  PDF  English version
  Views: 3253
  Downloads: 112

Resumo

 Introdução: A estimulação da medula espinhal (EME) tem sido estudada há muito tempo para tratamento da dor neuropática crônica. Estudos também têm associado a EME à melhora das manifestações axiais da Doença de Parkinson (DP), muitas vezes refratárias ao tratamento conservador e à Estimulação Cerebral Profunda. Relatamos um caso de melhora clínica do congelamento da marcha (FoG) da DP após estimulação medular. Relato do caso: Paciente do sexo masculino de 82 anos com história de 10 anos de DP sob tratamento farmacológico que proporcionou resolução do tremor, mas não do distúrbio da marcha. O paciente apresentou neuralgia pós-herpética refratária grave. Foi implantado um eletrodo epidural cervical para EME, resultando não apenas na melhora da dor neuropática, mas também na postura em DPe FoG, com o aumento da velocidade da marcha. Discussão: A EME é uma alternativa promissora no manejo das manifestações axiais da DP refratária à terapia farmacológica. A EME tem sido amplamente estudada no manejo da dor crônica, mas este relato e outros estudos publicados sugerem que a medula espinhal também pode ser um alvo interessante no tratamento da DP. Neste relato, o EME foi responsável pela melhora da marcha e postura em DP refratária com neuralgia pós-herpética.

Palavras-chave

Palavras-Chave: Doença de Parkinson; Estimulação da medula espinhal; Neuralgia pós-herpética; Neuromodulação

Abstract

 Background: Spinal Cord Stimulation (SCS) has long been studied for the treatment of chronic neuropathic pain. Nevertheless, studies have associated SCS with improvement of axial manifestations of Parkinson’s Disease (PD), which are often refractory to conservative treatment and Deep Brain Stimulation (DBS). We report a case of clinical improvement of PD’s freezing of gait (FoG) after spinal cord stimulation. Case presentation: Male patient, 82-year-old with a 10-year history of PD under a pharmacological treatment that provided resolution of tremor, but was unable to improve gait disturbance. The patient presented with severe refractory postherpetic neuralgia. A cervical epidural lead for SCS was implanted, resulting not only in improvement of neuropathic pain but also in parkinson’s posture and FoG. with an increase in gait speed. Discussion: SCS is a promising therapeutic alternative in the management of axial manifestations of PD refractory to pharmacological therapy. SCS has been thoroughly studied in the management of chronic pain, but this report and other published studies suggest that the spinal cord could also be an interesting target in the treatment of PD. Conclusion: In this report, SCS was responsible for improvement of gait and posture in a patient with refractory PD with postherpetic neuralgia.

Keywords

Keywords: Parkinson’s disease; Spinal cord stimulation; Postherpetic neuralgia; Neuromodulation

References

1. Kurklinsky S, Palmer SC, Arroliga MJ, Ghazi SM. Neuromodulation in postherpetic neuralgia: case reports and review of the literature. Pain Med. 2018;19(6):1237-44. http://dx.doi.org/10.1093/pm/pnx175. PMid:29016994.
2. Schmader KE, Dworkin RH. Natural history and treatment of herpes zoster. J Pain. 2008;9(1, Suppl. 1):S3 -9. http://dx.doi.org/10.1016/j. jpain.2007.10.002. PMid:18166460.
3. Scholz J, Finnerup NB, Attal N, et al. The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain. 2019;160(1):53-9. http://dx.doi.org/10.1097/j.pain.0000000000001365. PMid:30586071.
4. Lin C-S, Lin Y-C, Lao H-C, Chen C-C. Interventional treatments for postherpetic neuralgia: a systematic review. Pain Physician. 2019;22(3):209-28. http://dx.doi.org/10.36076/ppj/2019.22.209. PMid:31151330.
5. Tysnes O-B, Storstein A. Epidemiology of Parkinson’s disease. J Neural Transm. 2017;124(8):901-5. http://dx.doi.org/10.1007/s00702- 017-1686-y. PMid:28150045.
6. Thenganatt MA, Jankovic J. Parkinson disease subtypes. JAMA Neurol. 2014;71(4):499-504. http://dx.doi.org/10.1001/jamaneurol.2013.6233. PMid:24514863.
7. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008;79(4):368-76. http://dx.doi.org/10.1136/ jnnp.2007.131045. PMid:18344392.
8. Andrade EM, Ghilardi MG, Cury RG, et al. Spinal cord stimulation for Parkinson’s disease: a systematic review. Neurosurg Rev. 2016;39(1):27- 35, discussion 35. http://dx.doi.org/10.1007/s10143-015-0651-1. PMid:26219854.
9. Fonoff ET, de Lima-Pardini AC, Coelho DB, et al. Spinal cord stimulation for freezing of gait: from bench to bedside. Front Neurol. 2019;10:905. http://dx.doi.org/10.3389/fneur.2019.00905. PMid:31507514.
10. Lima-Pardini AC, Coelho DB, Souza CP, et al. Effects of spinal cord stimulation on postural control in Parkinson’s disease patients with freezing of gait. eLife. 2018;7:e37727. http://dx.doi.org/10.7554/ eLife.37727. PMid:30070204.
11. Lai Y, Pan Y, Wang L, Zhang C, Sun B, Li D. Spinal cord stimulation with surgical lead improves pain and gait in Parkinson’s disease after a dislocation of percutaneous lead: a case report. Stereotact Funct Neurosurg. 2020;98(2):104-9. http://dx.doi.org/10.1159/000505707. PMid:32097953.
12. Samotus O, Parrent A, Jog M. spinal cord stimulation therapy for gait dysfunction in advanced Parkinson’s disease patients. Mov Disord. 2018;33(5):783-92. http://dx.doi.org/10.1002/mds.27299. PMid:29442369.
13. Furusawa Y, Matsui A, Kobayashi-Noami K, et al. Burst spinal cord stimulation for pain and motor function in Parkinson’s disease: a case series. Clin Park Relat Disord. 2020;3:100043. http://dx.doi. org/10.1016/j.prdoa.2020.100043. PMid:34316628.
14. Mazzone P, Viselli F, Ferraina S, et al. High Cervical spinal cord stimulation: a one year follow-up study on motor and non-motor functions in Parkinson’s disease. Brain Sci. 2019;9(4):78. http://dx.doi. org/10.3390/brainsci9040078. PMid:30987170.
15. Pinto de Souza C, Hamani C, Oliveira Souza C, et al. Spinal cord stimulation improves gait in patients with Parkinson’s disease previously treated with deep brain stimulation. Mov Disord. 2017;32(2):278-82. http://dx.doi.org/10.1002/mds.26850. PMid:27862267.
16. Agari T, Date I. Spinal cord stimulation for the treatment of abnormal posture and gait disorder in patients with Parkinson’s disease. Neurol Med Chir. 2012;52(7):470-4. http://dx.doi.org/10.2176/nmc.52.470. PMid:22850494.
17. Akiyama H, Nukui S, Akamatu M, Hasegawa Y, Nishikido O, Inoue S. Effectiveness of spinal cord stimulation for painful camptocormia with Pisa syndrome in Parkinson’s disease: a case report. BMC Neurol. 2017;17(1):148. http://dx.doi.org/10.1186/s12883-017-0926-y. PMid:28774283.
18. Chakravarthy KV, Chaturvedi R, Agari T, Iwamuro H, Reddy R, Matsui A. Single arm prospective multicenter case series on the use of burst stimulation to improve pain and motor symptoms in Parkinson’s disease. Bioelectron Med. 2020;6(1):18. http://dx.doi.org/10.1186/ s42234-020-00055-3. PMid:33005705.
19. Nishioka K, Nakajima M. Beneficial therapeutic effects of spinal cord stimulation in advanced cases of Parkinson’s disease with intractable chronic pain: a case series. Neuromodulation. 2015;18(8):751-3. http:// dx.doi.org/10.1111/ner.12315. PMid:26047363.
20. Thevathasan W, Mazzone P, Jha A, et al. Spinal cord stimulation failed to relieve akinesia or restore locomotion in Parkinson disease. Neurology. 2010;74(16):1325-7. http://dx.doi.org/10.1212/WNL.0b013e3181d9ed58. PMid:20404313.
21. Hassan S, Amer S, Alwaki A, Elborno A. A patient with Parkinson’s disease benefits from spinal cord stimulation. J Clin Neurosci. 2013;20(8):1155-6. http://dx.doi.org/10.1016/j.jocn.2012.08.018. PMid:23453160.

1 MD, MR, Medical Residency in Neurosurgery, Department of Neurosurgery, Santa Paula Hospital, São Paulo, SP, Brazil.

2 MS, Medical student, Graduation Medicine, Department of Medicine, Marília Medical School – FAMEMA, Marília, SP, Brazil.

3 MD, Neurosurgeon, Graduation Medicine, Department of Medicine, Marília Medical School – FAMEMA, Marília, São Paulo, Brazil.

4 MD, PhD, Neurosurgeon, Department of Neurosurgery, Santa Paula Hospital, São Paulo, SP, Brazil.

5 MD, PhD, Neurosurgeon, Laboratory of Cellular and Molecular Biology, Department of Research and Innovation, Medical School of ABC, Santo André, SP, Brazil.

6 MD, PhD, Neurosurgeon, Department of Neurology, Pontifical Catholic University of São Paulo, Sorocaba, SP, Brazil.

 

Received Apr 9, 2022

Accepted Jul 12, 2022

  Voltar

JBNC  Brazilian Journal of Neurosurgery

JBNC
  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786
iThenticate
Open Access

Contact

Social Media

   

ABNc  Academia Brasileira de Neurocirurgia

  •   Rua da Quitanda 159 – 10º andar - Centro - CEP 20091-005 - Rio de Janeiro - RJ
  •   +55 21 2233.0323
  •    abnc@abnc.org.br

Sponsor

  • Brain4Care
  • Hospital INC
  • Strattner
  • Zeiss