• Gianni Colini Baldeschi and Giandomenico Babbolin.
• Pain Unit, S. Giovanni Addolorata Hospital, Rome, Italy; and Anesthesiology Unit, Cittadella Hospital, Cittadella, Padua, Italy.
• Neuromodulation. 2007 Jan 1;10(1):12-7.

AbstractWe present a case of a female patient suffering from type I complex regional pain syndrome (CRPS) who developed "mirror imaging" of her CRPS and was successfully treated with dual spinal cord stimulation (SCS) in the paraforaminal epidural space. This patient initially had unilateral pain that was unsuccessfully treated with midline SCS and single-lead lateral epidural lead placement "paraforaminally." One year later, because we believed that paraforaminal stimulation would preferentially stimulate primary sensitized afferents innervating the painful area, we reperformed SCS with two leads positioned laterally and paraforaminally close to the roots within the epidural space. After repositioning and after 1 year of paraforaminal stimulation, there was significant improvement in the patient's symptoms, resolving all unilateral and "mirrored" symptoms. We conclude that paraforaminal stimulation may be a valid therapeutic option for the treatment of CRPS.

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