Peripheral nerve stimulation apparatus

Abstract

A method for treating pain by subcutaneous electrical stimulation of a peripheral nerve is disclosed. A lead is placed subcutaneously over a peripheral nerve that is causing pain. The peripheral nerve is electrically stimulated to cause paresthesia. The method encompasses subcutaneous placement of an electrical lead near any peripheral nerve causing pain and subsequent electrical stimulation of the nerve to cause paresthesia. In particular, a method for treating intractable occipital neuralgia using percutaneous peripheral nerve electrostimulation techniques is disclosed.

What is claimed is:  
     
         1 . An apparatus for treating neuralgia emanating from a peripheral nerve of a patient comprising in combination: 
 (a) an implantable signal generator for providing electrical stimulation;    (b) an implantable lead having a proximal end coupled to the signal generator and a stimulation portion adapted to be implanted in a fascia superior to and near the peripheral nerve to cause paresthesia of a neuralgia emanating area,    whereby the implantable signal generator is capable of providing electrical stimulation to the peripheral nerve via the stimulation portion of the implantable lead to cause parasthesia of the neuralgia emanating area.    
     
     
         2 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , wherein the neuralgia is selected from the group consisting of post herpetic neuralgia, chronic deafferentation pain, chronic peripheral nerve pain, post crainiotomy pain, incisional pain, clunial pain, post herniorrhapy pain, localized low back or other spine pain, incisional neuroma pain, stump neuroma pain, incisional scar pain, deafferention pain, chronic peripheral nerve pain, sciatic neuralgia, medical neuralgia and ulnar neuralgia.  
     
     
         3 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , further comprising an introducer needle capable of being placed in the fascia superior to the peripheral nerve and capable of passing the implantable lead so that the stimulation portion is in position above the peripheral nerve.  
     
     
         4 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 3 , wherein the introducer needle is curved so as to conform to a contour of the patient's body superior to the peripheral nerve.  
     
     
         5 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , wherein the implantable lead is a dual lead.  
     
     
         6 . The apparatus for treating neuralgia emanating from a peripheral nerve of claim  1 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a supraorbital nerve.  
     
     
         7 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a clunial nerve.  
     
     
         8 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a iliolinguinal nerve.  
     
     
         9 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a median nerve.  
     
     
         10 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , wherein the stimulation portion of the implantable lead is adapted to be implanted near an ulnar nerve.  
     
     
         11 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a sciatic nerve.  
     
     
         12 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 1 , further comprising a screening device capable of being coupled to the implantable lead for performing test electrical stimulation with the implantable lead.  
     
     
         13 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 12 , wherein the screening device is capable of delivering electrical stimulation having an amplitude between about 0.5 to about 4.0 volts.  
     
     
         14 . The apparatus for treating neuralgia emanating from a peripheral nerve of claim  12 , wherein the screening device is capable of delivering electrical stimulation having a rate between about 50 Hz to about 400 Hz.  
     
     
         15 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 12 , wherein the screening device is capable of delivering electrical stimulation having a pulse width between about 90 μsec to about 200 μsec.  
     
     
         16 . An apparatus for treating neuralgia emanating from a peripheral nerve of a patient comprising in combination: 
 (a) an RF system transmitter for generating RF signals;    (b) an implantable RF system receiver for providing electrical stimulation in response to the RF signals;    (c) an implantable lead having a proximal end coupled to the implantable RF system receiver and a stimulation portion adapted to be implanted in a fascia superior to and near the peripheral nerve to cause paresthesia of a neuralgia emanating area,    whereby the implantable RF system receiver is capable of providing electrical stimulation to the peripheral nerve via the stimulation portion of the implantable lead to cause parasthesia of the neuralgia emanating area.    
     
     
         17 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the neuralgia is selected from the group consisting of post herpetic neuralgia, chronic deafferentation pain, chronic peripheral nerve pain, post crainiotomy pain, incisional pain, clunial pain, post herniorrhapy pain, localized low back or other spine pain, incisional neuroma pain, stump neuroma pain, incisional scar pain, deafferention pain, chronic peripheral nerve pain, sciatic neuralgia, medical neuralgia and ulnar neuralgia.  
     
     
         18 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , further comprising an introducer needle capable of being placed in the fascia superior to the peripheral nerve and capable of passing the implantable lead so that the stimulation portion is in position above the peripheral nerve.  
     
     
         19 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 18 , wherein the introducer needle is curved so as to conform to a contour of the patient's body superior to the peripheral nerve.  
     
     
         20 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the implantable lead is a dual lead.  
     
     
         21 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a supraorbital nerve.  
     
     
         22 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a clunial nerve.  
     
     
         23 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a iliolinguinal nerve.  
     
     
         24 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a median nerve.  
     
     
         25 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the stimulation portion of the implantable lead is adapted to be implanted near an ulnar nerve.  
     
     
         26 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 16 , wherein the stimulation portion of the implantable lead is adapted to be implanted near a sciatic nerve.  
     
     
         27 . The apparatus for treating neuralgia emanating from a peripheral nerve of claim  16 , further comprising a screening device capable of being coupled to the implantable lead for performing test electrical stimulation with the implantable lead.  
     
     
         28 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 27 , wherein the screening device is capable of delivering electrical stimulation having an amplitude between about 0.5 to about 4.0 volts.  
     
     
         29 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 27 , wherein the screening device is capable of delivering electrical stimulation having a rate between about 50 Hz to about 400 Hz.  
     
     
         30 . The apparatus for treating neuralgia emanating from a peripheral nerve of  claim 27 , wherein the screening device is capable of delivering electrical stimulation having a pulse width between about 90 μsec to about 200 μsec.  
     
     
         31 . An apparatus for treating neuralgia emanating from an occipital nerve of a patient comprising in combination: 
 (a) an implantable signal generator for providing electrical stimulation;    (b) an implantable lead having a proximal end coupled to the signal generator and a stimulation portion adapted to be implanted in a fascia superior to and near the occipital nerve to cause paresthesia of a neuralgia emanating area,    whereby the implantable signal generator is capable of providing electrical stimulation to the occipital nerve via the stimulation portion of the implantable lead to cause parasthesia of the neuralgia emanating area.    
     
     
         32 . The apparatus for treating neuralgia emanating from an occipital nerve of  claim 31 , wherein the implantable lead is capable of being placed at a level of C1 transversely across a base of an occipital nerve trunk and wherein the implantable signal generator is capable of providing electrical stimulation to the occipital nerve trunk.  
     
     
         33 . An apparatus for treating neuralgia emanating from an occipital nerve of a patient comprising in combination: 
 (a) an RF system transmitter for generating RF signals;    (b) an implantable RF system receiver for providing electrical stimulation in response to the RF signals;    (c) an implantable lead having a proximal end coupled to the implantable RF system receiver and a stimulation portion adapted to be implanted in a fascia superior to and near the occipital nerve to cause paresthesia of a neuralgia emanating area,    whereby the implantable RF system receiver is capable of providing electrical stimulation to the occipital nerve via the stimulation portion of the implantable lead to cause parasthesia of the neuralgia emanating area.    
     
     
         34 . The apparatus for treating neuralgia emanating from an occipital nerve of  claim 33 , wherein the implantable lead is capable of being placed at a level of C1 transversely across a base of an occipital nerve trunk and wherein the implantable RF system receiver is capable of providing electrical stimulation to the occipital nerve trunk.