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Neurologic Injury After Sacral Neuromodulation

Yuan, Angela S. MD*; Almodovar, Jorge L. MD; Erekson, Elisabeth MD, MPH*‡

Female Pelvic Medicine & Reconstructive Surgery: March/April 2019 - Volume 25 - Issue 2 - p e45–e46
doi: 10.1097/SPV.0000000000000701
Case Reports
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Objective Neurologic injury after sacral nerve stimulation (SNS) is rare, but the incidence is unknown. Infection is a potential mechanism for neurologic damage. This report illustrates the presentation, pathophysiology, diagnostic considerations, and treatment of epidural infection causing neurologic deficits after SNS.

Case Report We present a case of a woman with severe fecal incontinence due to Crohn’s disease who underwent SNS implantation and subsequently developed a wound infection requiring complete device explantation. A few days later, she presented with leg pain and weakness. Urgent evaluation and treatment of epidural infection were performed. She had persistent neurologic deficits 6 months later.

Conclusions Neurologic sequelae from an infection after SNS are a rare event and should be considered in patients with fevers, leg pain, and neurologic deficits.

From the *Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, NH;

Department of Neurology, Dartmouth-Hitchcock, Manchester; and

The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH.

Correspondence: Angela S. Yuan, MD, Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756. E-mail: angela.s.yuan@hitchcock.org.

The authors have declared they have no conflicts of interest.

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