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His magnetic resonance imaging (MRI) showed a diffuse atrophic change ranging from the lower cervical to lumbar spine ( Fig. Subsequently, he had suffered from neuropathic pain below the T3 level, and motor weakness of grade IV in the lower extremities, for 15 years. He underwent resection of schistosomiasis-related granulomas on the cerebella, and the T3-4 level of the spinal cord, at another hospital. After he returned to our country, he experienced motor weakness, voiding difficulty, dizziness, and hypesthesia. He had worked in Middle Eastern countries for several years and had developed hypesthesia on legs during that time. Here, we report the outcome and technical details of the treatment of this patient with a pertinent literature.Ī 53-year-old male patient presented to our hospital with intractable neuropathic pain below the T3 level as a result of spinal cord injury suffered after transverse myelitis caused by schistosomiasis. We experienced a good outcome after application of cervical cord stimulation to a patient with intractable pain arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. Such pain is inadequately controlled by medication such as NSAIDs, opioids, or anticonvulsants. Myelopathy arising from schistosomiasis has been reported in several studies and may cause intractable neuropathic pain 1, 17). In addition, the cervical level has been employed for treatment of facial, neck, and upper extremity lesions arising from cord injury, brachial plexus damage, and CRPS 21).Ĭentral nervous system schistosomiasis has been described in soldiers and workers in endemic areas. For example, the lower thoracic level has been commonly used in patients with FBSS 4, 6, 14), stimulation at the thoracolumbar junction has been useful in treating foot pain patients 6), and the cervico-thoracic junction was appropriate to control angina pectoris pain 4, 6, 14). The target level for placement of the SCS electrode differs according to pain location. Since then, many physicians have extended the indications for SCS, which now include various pain syndromes, failed back surgery syndrome (FBSS), phantom limb pain, complex regional pain syndrome (CRPS), brachial plexus injury, and angina pectoris. The first use of an electrode was reported in 1967 by Shealy 4). Spinal cord stimulation (SCS) has been regarded as an effective treatment modality for chronic pain patients.