Pain practice : the official journal of World Institute of Pain
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Case Reports
Peripheral neurostimulation in supraorbital neuralgia refractory to conventional therapy.
Supraorbital neuralgia has been identified as an infrequent cause of headache that may prove very difficult to control pharmacologically. Peripheral nerve stimulation using electrodes to stimulate the nerve segmentally responsible for the zone of pain may constitute a management alternative in such cases. We present the case of a patient with headache because of posttraumatic supraorbital neuralgia, refractory to medical treatment, with good analgesic control after peripheral nerve stimulation. Peripheral nerve stimulation may be considered a safe, reversible treatment for patients with headache secondary to supraorbital neuralgia who respond poorly to pharmacological treatment, thus avoiding irreversible alternatives such as surgery.
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Median arcuate ligament syndrome, which presents with intractable visceral pain, is difficult to both diagnose and treat. This case report describes the first use of an intrathecal morphine pump as an effective therapeutic intervention. ⋯ The use of an intrathecal narcotic pump should be considered for treatment of patients with intractable visceral pain secondary to median arcuate ligament syndrome.