Abstract
A case of causalgia treated by the PISCES spinal cord stimulation system (produced by Medtronic, U.S.A.) was reported. The patient was a 48-year-old man who sustained partial damage to the right median nevre about seven years ago during an open brachial angiography in another hospital as a preoperative examinatior for a ruptured mycotic aneurysm in the left occipital region. The mycotic aneurysm was successfully treatec leaving right homonymous hemianopsia. However, he suffered from weakness in flexion of the fingers and spo. ntaneous severe pain in the distribution of the median nerve since that time. Motor functions had recovered almos to normal after median nerve neurolysis on several occasions, but the disagreeable pain remained unchanged.
He obtained an excellent immediate effect from percutaneously inserted spinal cord electrical stimulation Since this system in not widely used in Japan, the method and our experience in this case were described in detai and the literature was reviewed. In conclusion, intractable chronic pain with hyperpathia seems to be one of the most favorable candidates for this mode of treatment. This stimulation method is easy to perform and should be applied before considering other more destructive procedures for pain relief.
