Allergic Reaction to Peripheral Nerve Stimulator

ABSTRACT

Objective: Pain physicians should be aware of a rare but possible complication associated with the use of pe-ripheral nerve stimulation. While pacemaker dermatitis and allergic reactions to a spinal cord stimulator have been recog-nized, there have been no case studies of allergic reactions to a peripheral nerve stimulator described in the literature. Method: We presented a case report where the patient developed a post-operative allergic reaction. The symptoms re-ported were itching, a rash on the scalp, and a rash on the back of cervical and thoracic spine and buttocks, where the bi-lateral occipital peripheral nerve stimulator leads and pulse generator had been implanted for the patient’s cervicogenic headache. Result: The patient experienced excellent relief of her headache and associated symptoms after stimulation therapy. However, she developed a skin reaction immediately after surgery and her symptoms gradually became severe and systemic. Conservative treatment and modalities failed to provide relief. Ultimately, her symptoms completely re-solved after the device was removed. Conclusion: An individual with a history of a significant allergic disease may de-velop an allergic reaction to the components of the peripheral nerve stimulation device. The details of a ptatient's allergy history and a patch test of the nerve stimulator components are necessary in this group of patients before proceeding with peripheral nerve stimulation therapy. If the patient with an allergic reaction to the implanted device fails conservative therapy, then removal of the device should provide definitive treatment and relief of the allergy associated symptoms.

Keywords:

Occipital nerve stimulation, chronic headache, cervicogenic headache, allergic reaction, Spinal cord stimulation, Peripheral nerve stimulation.