Background & Aims
This article describes a case of a young woman with meralgia paraesthetica (chronic burning pain) who underwent spinal cord stimulation (SCS) for pain management. The aim is to explore a rare complication – sudden sensorineural hearing loss – that occurred following the procedure.
Methods
A detailed case report is presented, including the patient’s medical history, the SCS procedure, and subsequent complications.
Literature review is conducted to explore the potential link between spinal interventions (including SCS) and sensorineural hearing loss.
Results
– The patient’s SCS procedure was successful technically with no cerebrospinal fluid (CSF) leak.
– Shortly after the procedure, she developed symptoms like headache, nausea, and neck stiffness. These were diagnosed as post-dural puncture headache (PDPH).
– An epidural blood patch initially relieved the PDPH, but she presented again with balance problems and numbness in her toe.
– Neurological workup didn’t reveal any abnormalities related to low CSF pressure.
– The patient then developed tinnitus followed by a sudden 50 dB sensorineural hearing loss in one ear.
Conclusions
The article acknowledges the unclear cause of the hearing loss. It discusses two possibilities:
– Spinal interventions: The hearing loss could be a delayed consequence of the repeated spinal procedures (SCS implant, blood patch, lumbar puncture) causing pressure changes and nerve stretch.
– Coincidental event: The hearing loss could be unrelated to the procedures and a case of spontaneous sudden sensorineural hearing loss (SSNHL).
The article highlights the importance of considering hearing problems as a potential complication after spinal interventions, even in the absence of CSF leak or low CSF pressure. It also emphasizes the need for further research on the mechanisms of such complications.
References
1. Wildsmith JA, Lee LA, Neurological
sequelae of spinal anaesthesia. BJA
1989; 63:505-508.
2. Sensorineural hearing loss following
lumbar puncture, spinal anaesthesia
or epidural anaesthesia: a case series
and literature review. M Alwan and G
Hurtado.
3. The Incidence and Management
of Postdural Puncture Headache in
Patients Undergoing Percutaneous
Lead Placement for Spinal Cord
Stimulation. Thomas T. Simopoulos,
Sanjiv Sharma, Musa Aner, Jatinder S.
Gill
4. Sudden Sensorineural Hearing Loss:
A Review of Diagnosis, Treatment, and
Prognosis. Maggie Kuhn, Selena E.
Heman-Ackah, Jamil A. Shaikh, and
Pamela C. Roehm
5. Blood patch for the treatment of postdural puncture tinnitus. Wei Jia and
Fiqry Fadhlillah
Presenting Author
Ahmad Mohammad Obeidat
Poster Authors
Topics
- Treatment/Management: Interventional Therapies – Neuromodulation