Presented by:  Dr.Kris Kumar Neurosurgeon, Regina

Age:  40

Sex:  Male

History:

• 1997 - Left sciatic pain.

• 1998 - L5-S1 left disc surgery without improvement.

• Extensive investigations by way of MRI shows epidural and perineural fibrosis.  Had a trial of epidural and ganglion steroid blocks without benefit.  Physiotherapy administered with no relief.

• November 2000 - Spinal cord implant.  Good relief.

• April 2001 - Started to complain of episodes of sharp electric sensation in front of both thighs which will come irrespective of the fact whether the stimulation is on or off.  This may last for several seconds at a time.  

• Last review in January of 2002 still continues to have electric shock-like feeling.  Neurological examination remains normal.  The electrode appears intact.  The stimulation induced paresthesia is felt in the territory of pain.  

Investigations: 

Lumbar and dorsal spine shows no fracturing of the electrode.

Questions:

• What is the cause of the electric shocks which are felt in the front of the thigh irrespective whether the stimulation is on or off?
• As the patient continues to get good pain relief with the stimulation program what should be the next option?