# Acute Uremic Encephalopathy in an Adult Patient Due to Urinary Retention After Spinal Cord Stimulation: A Case Report and Literature Review

## TL;DR

A 59-year-old patient developed uremic encephalopathy due to urinary retention after spinal cord stimulation, highlighting a rare but reversible complication.

## Contribution

This is the second reported case of uremic encephalopathy as a rare complication of spinal cord stimulation.

## Key findings

- Urinary retention following SCS can lead to uremic encephalopathy.
- Prompt deactivation and reprogramming of the SCS system led to full recovery.
- Awareness of atypical autonomic complications is crucial for safe SCS use.

## Abstract

Spinal cord stimulation (SCS), following the gate control theory of pain, has progressively evolved into an established neuromodulation technique for the treatment of refractory neuropathic pain. Although SCS is generally regarded as a safe procedure, complications are rare, with the majority related to hardware malfunction or minor biological events. Severe neurological or systemic complications are quite rare, while autonomic disturbances such as urinary retention or altered consciousness are considered exceptionally uncommon. We present a clinical case of a 59-year-old patient with urinary disturbances (retention), leading to clinical representation of uremic encephalopathy week after implantation of SCS. In parallel, a structured literature review was conducted using PubMed/MEDLINE and additional medical databases, focusing on SCS-related neurological and autonomic complications. Our report is the second to report and highlight a rare but reversible complication of SCS. Early recognition, prompt deactivation of the stimulation system, and careful reprogramming may lead to complete clinical recovery. While SCS remains an effective therapy for refractory neuropathic pain, awareness of atypical neurological and autonomic adverse effects is essential for safe clinical practice.