Ultrasound-guided percutaneous temporary vagus nerve stimulation for refractory post-traumatic chronic pain and post-traumatic stress disorder (PTSD): first reported case and implantation technique.

Authors

Hesham Elsharkawy, Amara Breanne Ajon, Karim Elsharkawy, Faria Nisar

Published in

Regional anesthesia and pain medicine. Sep 11, 2026. Epub Sep 11, 2026.

Abstract

Post-traumatic stress disorder (PTSD) and chronic pain frequently coexist and are often refractory to conventional therapies. Vagus nerve stimulation (VNS) has emerged as a potential neuromodulatory approach targeting autonomic dysregulation and central pain pathways. VNS has traditionally been delivered using either transcutaneous approaches or surgical implantation; however, to the best of our knowledge, ultrasound-guided percutaneous peripheral nerve stimulation targeting the vagus nerve has not previously been described.
We present the case of a female in her late 20s with refractory chronic pain syndrome, PTSD, post-traumatic headaches, and occipital neuralgia following multiple traumatic brain injuries sustained during domestic violence. After failing conservative management, the patient underwent ultrasound-guided percutaneous implantation of a left vagus nerve peripheral nerve stimulator for 60 days and demonstrated remarkable improvement. Over an 8-week period of temporary implantation, pain scores decreased from 10/10 to 0/10, with concomitant resolution of gastrointestinal symptoms, fatigue, and PTSD symptoms. Analgesic improvement was sustained at 4-month follow-up, while PTSD symptom scores measured using the PTSD Checklist for DSM-5 (PCL-5) increased during the same time interval. Because a baseline pre-procedure PCL-5 score was not available, the overall magnitude of change relative to the patient's pretreatment status cannot be determined despite PTSD symptom scores increasing during follow-up.
We present the use of the 60-day percutaneous temporary implantation of VNS for PTSD and chronic post-traumatic pain, along with a detailed description of the ultrasound-guided implantation technique.

PMID:
42727982
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.