Seizure Provocation Following Low-Energy Burst Dorsal Root Spinal Cord Stimulator Implant in Patient with Chronic Back Pain and Pre-Existing Seizures: Case Report.

BACKGROUND: Spinal cord stimulation (SCS) is an established treatment of chronic pain refractory to conservative management. While it is thought to work through neuromodulation of spinal cord pathways, its impact on central nervous system excitability is not well understood. There are afew reports highlighting seizures temporally associated with SCS. CASE REPORT: This case involves a 78-year-old man with chronic low back pain secondary to lumbar facet arthropathy and a history of seizure disorder. He underwent spinal cord stimulator implantation after failing conservative management for back pain. The implant provided significant pain relief and functional improvement. However, within 9 months of implantation, he developed recurrent seizures. Seizure activity ceased after removal of the SCS, but unfortunately, his pain returned. CONCLUSIONS: This case highlights the unusual and poorly understood complication of SCS-induced seizures, emphasizing the need for caution when considering neuromodulation therapy in patients with a known seizure history.