Sixth nerve palsy following epidural spinal cord stimulation for lower limb ischaemia

Lower Limb Rehabilitation Following Spinal Cord Injury

Spinal cord stimulation to achieve wound healing in a primary lower limb critical ischaemia referral centre.

Critical lower limb ischaemia is a diffuse pathology that could cause claudication, severe ischaemic pain and tissue loss. The common treatment includes modification of risk factors, pharmacological therapy and endovascular or surgical revascularisation of the lower limb to restore a pulsatile flow distally. Spinal cord stimulator is seen as a valid alternative in patients unsuitable for revasc...

Spinal cord stimulation is not cost-effective for non-surgical management of critical limb ischaemia.

OBJECTIVE To quantify the costs of treatment in critical limb ischaemia (CLI) and to compare costs and effectiveness of two treatment strategies: spinal cord stimulation (SCS) and best medical treatment. METHODS One hundred and twenty patients with CLI not suitable for vascular reconstruction were randomised to either SCS in addition to best medical treatment or best medical treatment alone. ...

Isolated sixth nerve palsy

An isolated sixth nerve palsy may be a harbinger of underlying intracranial disease. Due to its long subarachnoid course, it may be damaged by downward shift of the brainstem as often occurs in increased or decreased intracranial pressure (“false-localizing sixth nerve palsy”). Alternatively, the sixth nerve may be involved in isolation by a compressive lesion in the cavernous sinus or along th...

Epidural hematoma following spinal cord stimulator implant

A 50-year-old male with chronic low-back pain presented to the ED with mid-back pain, numbness, paresthesia and weakness in both legs. These symptoms were preceded by a sudden onset of paralysis below the waistline without loss of bowel or bladder control, which occurred during the surgical placement of a neurostimulator. The device was immediately removed, and the patient’s paralysis partially...