scholarly journals Duloxetine Contributing to a Successful Multimodal Treatment Program for Peripheral Femoral Neuropathy and Comorbid ‘Reactive Depression’ in an Adolescent

2011 ◽  
Vol 16 (6) ◽  
pp. 457-459 ◽  
Author(s):  
Ludmyla Kachko ◽  
Shiri Ben Ami ◽  
Alon Liberman ◽  
Einat Birk ◽  
Sefi Kronenberg

In the United States, duloxetine has been approved for the treatment of major depressive disorder, diabetic peripheral neuropathic pain and fibromyalgia in the adult population. Data regarding the use of duloxetine in the pediatric population, however, are very limited. Femoral nerve injury is a rare complication of cardiac catheterization. In the case described, duloxetine contributed to a successful multimodal treatment program for peripheral neuropathic pain due to femoral neuropathy in an adolescent with ‘reactive depression’ and conversion symptoms. To the best of the authors’ knowledge, the present article is only the third such report on this dual use of duloxetine in children and adolescents, and the first report of such treatment following femoral neuropathy induced by cardiac catheterization.

Spine ◽  
2000 ◽  
Vol 25 (2) ◽  
pp. 238 ◽  
Author(s):  
Alexander A. Vendrig ◽  
Pieter F. van Akkerveeken ◽  
Kevin R. McWhorter

2009 ◽  
Vol 4;12 (4;7) ◽  
pp. E305-E308
Author(s):  
Samer N Narouze

Background: Femoral nerve injury is a rare complication of cardiac catheterization and is usually caused by direct trauma during femoral artery access, compression from a hematoma, or prolonged digital pressure for post-procedural hemostasis. Peripheral nerve stimulation has been used to treat different pain syndromes in the upper and lower extremities with variable success and it typically requires direct vision with open surgical approach. Since the femoral nerve can be readily seen with ultrasonography, an ultrasound-guided lead placement seemed practical. Case Report: A 61-year-old morbidly obese male who sustained femoral nerve injury during cardiac catheterization continued to complain of intractable femoral neuropathy 18 months afterwords. He failed multiple treatment modalities and continued to complain of severe neuropathic pains that markedly interfere with his daily activities. Two percutaneous leads were placed under real-time ultrasonography and the placement was confirmed with fluoroscopy. One lead was placed along the longitudinal axis of the nerve and the patient had good coverage over the anterior thigh but not below the knee. So another lead was placed horizontally across the femoral nerve in order to stimulate all the branches and the patient reported good coverage along the saphenous nerve distribution down to the foot. Results: The patient continues to be pain free 20 months after the implant. Conclusion: Here we described a novel non-invasive percutaneous approach for femoral nerve stimulation with ultrasound guidance which allowed precise placement of the stimulating lead very close to the femoral nerve without the need for surgical exploration. Key words: Femoral nerve stimulation, femoral neuropathy, ultrasound-guided lead implant, peripheral nerve stimulation


Pain Medicine ◽  
2015 ◽  
Vol 16 (11) ◽  
pp. 2075-2083 ◽  
Author(s):  
Mei Yang ◽  
Chunlin Qian ◽  
Yifei Liu

Pain Practice ◽  
2013 ◽  
Vol 14 (3) ◽  
pp. E146-E151 ◽  
Author(s):  
Christoph Pieh ◽  
Susanne Neumeier ◽  
Thomas Loew ◽  
Jürgen Altmeppen ◽  
Michael Angerer ◽  
...  

Pain ◽  
1997 ◽  
Vol 73 (1) ◽  
pp. 77-85 ◽  
Author(s):  
Michael Pfingsten ◽  
Jan Hildebrandt ◽  
Eric Leibing ◽  
Carmen Franz ◽  
Petra Saur

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