Abstract
BACKGROUND: Neuromodulation is a commonly used technique in adult pain management, with current off-label use of peripheral nerve stimulators for the treatment of occipital neuralgia. This targeted therapy can help avoid systemic medications and treat refractory symptoms. CASE REPORT: We present a 17-year-old boy with significant lesser occipital neuralgia and hydrocephalus status post ventriculoperitoneal shunt placement. He had occipital neuralgia treatment failures with both medication trials and surgical decompression in conjunction with physical and psychological therapies, eventually requiring weekly lesser occipital nerve blocks for pain relief. Our patient experienced a substantial reduction in pain and increase in functional recovery after the placement of a permanent peripheral nerve stimulator without disruption of his ventriculoperitoneal shunt. CONCLUSION: Peripheral nerve stimulator implantation can be safe and efficacious for the treatment of refractory occipital neuralgia in a pediatric patient with an ipsilateral ventriculoperitoneal shunt. KEY WORDS: Peripheral nerve stimulation, occipital neuralgia, pediatric, chronic pain, neuromodulation
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