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  4. Targeted dorsal root entry zone stimulation alleviates pain due to meralgia paresthetica
 
research article

Targeted dorsal root entry zone stimulation alleviates pain due to meralgia paresthetica

Aureli, Viviana
•
Vat, Molywan
•
Hankov, Nicolas
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December 1, 2022
Journal Of Neural Engineering

Objective. Meralgia paresthetica (MP) is a mononeuropathy of the exclusively sensory lateral femoral cutaneous nerve (LFCN) that is difficult to treat with conservative treatments. Afferents from the LFCN enter the spinal cord through the dorsal root entry zones (DREZs) innervating L2 and L3 spinal segments. We previously showed that epidural electrical stimulation of the spinal cord can be configured to steer electrical currents laterally in order to target afferents within individual DREZs. Therefore, we hypothesized that this neuromodulation strategy is suitable to target the L2 and L3 DREZs that convey afferents from the painful territory, and thus alleviates MP related pain. Approach. A patient in her mid-30s presented with a four year history of dysesthesia and burning pain in the anterolateral aspect of the left thigh due to MP that was refractory to medical treatments. We combined neuroimaging and intraoperative neuromonitoring to guide the surgical placement of a paddle lead over the left DREZs innervating L2 and L3 spinal segments. Main results. Optimized electrode configurations targeting the left L2 and L3 DREZs mediated immediate and sustained alleviation of pain. The patient ceased all other medical management, reported improved quality of life, and resumed recreational physical activities. Significance. We introduced a new treatment option to alleviate pain due to MP, and demonstrated how neuromodulation strategies targeting specific DREZs is effective to reduce pain confined to specific regions of the body while avoiding disconfort.

  • Details
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Type
research article
DOI
10.1088/1741-2552/aca5f7
Web of Science ID

WOS:000894814100001

Author(s)
Aureli, Viviana
Vat, Molywan
Hankov, Nicolas
Theaudin, Marie
Ravier, Jimmy  
Becce, Fabio
Demesmaeker, Robin  
Asboth, Leonie  
Courtine, Gregoire  
Bloch, Jocelyne
Date Issued

2022-12-01

Publisher

IOP Publishing Ltd

Published in
Journal Of Neural Engineering
Volume

19

Issue

6

Article Number

064001

Subjects

Engineering, Biomedical

•

Neurosciences

•

Engineering

•

Neurosciences & Neurology

•

meralgia paresthetica

•

spinal cord stimulation

•

neuromodulation

•

dorsal root entry zone

•

spinal-cord stimulation

•

electrical-stimulation

•

horn neurons

•

diagnosis

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

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Available on Infoscience
January 2, 2023
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/193556
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