ID: 216851 Use of Peripheral Nerve Stimulation for Lower Extremity Pain Due to Paraneoplastic Disorder

Abstract

A 73-year-old male with history of prostate cancer s/p resection admitted for multiple progressive mononeuropathies with a significant component of pain, specifically to his right lower extremity, was evaluated for consideration of peripheral nerve stimulation (PNS). The pain radiated from his right knee to his foot along the medial aspect, existed for four months, and was described as throbbing and burning that never resolved for which he required systemic opioids and multimodal analgesics. Given the progression of multiple mononeuropathies including cranial nerves, multiple lung nodules on imaging, and non-diagnostic nerve and muscle biopsies, the most likely etiology was paraneoplastic process, most likely lung or recurrence of prostate cancer. The patient underwent treatment with steroids, IVIG, and PLEX for the paraneoplastic disorder. The patient was considered for PNS to help alleviate his right lower extremity pain.