Spinal Cord Stimulation for the Treatment of Neuropathic Pain Related to Syringomyelia

Dear Editor: Syringomyelia is characterized by an intraspinal cavity and may cause central neuropathic pain associated with various painful symptoms. Typically, dysesthetic pain is the prominent feature in 40–90% of patients related to dissociated segmental sensory loss ⇓. Successful treatment is often difficult in part because the exact mechanisms of the pain remain uncertain ⇓. Based upon several published reports suggesting that spinal cord stimulation (SCS) may effectively treat certain neuropathic pain syndromes even if previously often resistant to various medications, we have successfully treated a patient with medication-resistant neuropathic pain related to syringomyelia ⇓. A 46-year-old Caucasian woman was referred to our pain clinic complaining of cervical pain for 4 years. The pain was located over her left cervical area from the occipital region down to the shoulder. The characteristics of pain were throbbing, burning, stabbing, and cramp-like. The pain was moderately exhausting and debilitating relative to movement (visual analog scale [VAS] = 8/10), emotional stress, and changes in environmental temperature (heat and cold), and was reduced by lying prone. Sensory examination revealed marked tactile and thermal hypoesthesia in the left occipital …