An unusual case of lead migration in occipital nerve stimulation: A case report and literature review

Atypical refractory occipital neuralgia treated with a unilateral dual-lead occipital nerve stimulator: a case report

Aim: To describe the successful treatment of atypical occipital neuralgia (ON) using a unilateral dual-lead occipital nerve stimulator.Setting: Outpatient clinic/operating room.Patient: A 53-year-old male with atypical ON.Case description: Patient was previously diagnosed with treatment-refractory left-sided trigeminal neuralgia with atypical occipital distribution. On presentation, his symptoms were consistent with ON with distribution to the left fronto-orbital area. He received a left-sided nerve stimulator implant targeting both the greater and lesser occipital nerves.Results: Patient reported pain relief from a numerical rating scale 10/10 to 3-4/10.Conclusion: ON with referred ipsilateral trigeminal distribution should be considered when patients present with simultaneous facial and occipital pain. Further, a dual-lead unilateral stimulator approach may be a viable treatment.

Superior Cluneal Nerve Stimulator Lead Displacement to the Thigh: A Case Report and Management Recommendations

CASE

An 82-year-old man with a history of lumbar spinal stenosis and prior laminectomy presented with chronic lower back pain and was treated with placement of bilateral superior cluneal nerve stimulators. At the 2-week follow-up, the patient reported loss of efficacy and new-onset paresthesia of the left lower extremity. Fluoroscopic evaluation revealed lead breakage and distal migration of the left-sided stimulator lead to the left anteromedial thigh.

CONCLUSION

Lead breakage and migration remains a challenge in peripheral nerve stimulation. This report illustrates the case of a nerve stimulator lead breakage and migration resulting in treatment failure and new-onset sensory disturbance.