Name of the Procedure:

Electronic analysis of implanted neurostimulator pulse generator/transmitter (e.g., contact group(s), interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation).

Summary

This procedure involves evaluating and adjusting the settings of an implanted neurostimulator to ensure it is functioning correctly and optimally managing symptoms. The neurostimulator is a device implanted under the skin that sends electrical impulses to the nerve to control pain or other neurological problems.

Purpose

The electronic analysis of a neurostimulator helps to adjust its settings for optimal performance in managing conditions such as chronic pain, movement disorders, or epilepsy. The goal is to maximize symptom relief while minimizing side effects.

Indications

• Chronic pain (e.g., back pain, neuropathic pain)
• Movement disorders (e.g., Parkinson's disease, essential tremor)
• Epilepsy (to reduce seizure frequency)
• Failure of conservative management with medications or other therapies

Preparation

• No specific fasting or medication adjustments are typically required.
• Pre-procedure assessments may include a review of the patient's symptoms and neurostimulator function.

Procedure Description

1. The patient visits the clinic where the neurostimulator is checked.
2. The healthcare provider uses a programmer to electronically read the neurostimulator settings.
3. Adjustments may be made to the voltage, frequency, pulse width, and other parameters based on the patient's response and symptoms.
4. The device may be tested in various settings to find the optimal configuration.
5. In some cases, patient feedback is used to fine-tune the settings in real-time.

Duration

The procedure typically takes 30 minutes to 1 hour, depending on complexity and patient feedback.

Setting

This is usually performed in an outpatient clinic or a specialized department within a hospital.

Personnel

• Neurologist
• Pain specialist
• Nurse or medical technician trained in neurostimulator programming

Risks and Complications

• Temporary discomfort during adjustments
• Rarely, changes in settings may initially cause worsening of symptoms
• Technical issues with the device or programmer

Benefits

• Improved symptom management
• Personalized settings for better comfort and efficacy
• Non-invasive adjustments without the need for additional surgical procedures

Recovery

• No recovery time needed as the procedure is non-invasive.
• Patients can usually resume normal activities immediately.
• Follow-up appointments may be scheduled to further refine settings based on long-term response.

Alternatives

• Adjustment of medications
• Other forms of neurostimulation or neuromodulation
• Surgical treatments for underlying conditions in some cases

Patient Experience

• Patients may feel slight tingling or pulsing sensations as the device settings are adjusted.
• Minimal discomfort is expected, and adjustments are often quick and straightforward.
• Pain management or comfort measures are generally not necessary, as the procedure is non-invasive.