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Open Access Highly Accessed Case report

Occipital peripheral nerve stimulation in the management of chronic intractable occipital neuralgia in a patient with neurofibromatosis type 1: a case report

Ioannis Skaribas12*, Octavio Calvillo12 and Evangelia Delikanaki-Skaribas12

Author Affiliations

1 Greater Houston Pain Consultants, Greater Houston Anesthesiology, 2411 Fountain View Drive #200, Houston, TX 77057-4832, USA

2 Department of Anesthesiology, University General Hospital, Houston, TX 77030, USA

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Journal of Medical Case Reports 2011, 5:174  doi:10.1186/1752-1947-5-174

Published: 10 May 2011

Abstract

Introduction

Occipital peripheral nerve stimulation is an interventional pain management therapy that provides beneficial results in the treatment of refractory chronic occipital neuralgia. Herein we present a first-of-its-kind case study of a patient with neurofibromatosis type 1 and bilateral occipital neuralgia treated with occipital peripheral nerve stimulation.

Case presentation

A 42-year-old Caucasian woman presented with bilateral occipital neuralgia refractory to various conventional treatments, and she was referred for possible treatment with occipital peripheral nerve stimulation. She was found to be a suitable candidate for the procedure, and she underwent implantation of two octapolar stimulating leads and a rechargeable, programmable, implantable generator. The intensity, severity, and frequency of her symptoms resolved by more than 80%, but an infection developed at the implantation site two months after the procedure that required explantation and reimplantation of new stimulating leads three months later. To date she continues to experience symptom resolution of more than 60%.

Conclusion

These results demonstrate the significance of peripheral nerve stimulation in the management of refractory occipital neuralgias in patients with neurofibromatosis type 1 and the possible role of neurofibromata in the development of occipital neuralgia in these patients.