# Repetitive Transcranial Magnetic Stimulation for Intractable Neuropathic Pain Following Post-Traumatic Lumbosacral Plexopathy: A Case Report

## TL;DR

A teenage girl with severe nerve pain from a spinal injury improved significantly after receiving a non-invasive brain stimulation treatment.

## Contribution

This case report demonstrates rTMS as a potential treatment for intractable neuropathic pain from post-traumatic LSP.

## Key findings

- High-frequency rTMS reduced the patient's pain intensity from 8 to 2 on the NRS scale.
- The treatment also improved the patient's mood and daily functioning.
- rTMS may serve as an effective adjunct for refractory neuropathic pain in traumatic LSP.

## Abstract

Background: Lumbosacral plexopathy (LSP) is characterized by severe neuropathic pain, motor weakness, and sensory deficits in the lumbosacral plexus region, often leading to significant functional impairment and reduced quality of life. Post-traumatic LSP is particularly challenging to treat due to its neuropathic nature and limited response to conventional pharmacologic therapies. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that has shown therapeutic potential for chronic neuropathic pain. Case Report: We report the case of a 16-year-old female who developed LSP following multiple pelvic fractures and subsequently exhibited disabling pain, depressive symptoms, and poor quality of life. High-frequency motor cortex rTMS resulted in meaningful clinical improvement in pain intensity (an NRS reduction from 8 to 2), mood, and daily functioning. Conclusions: This suggests the potential role of rTMS as an adjunctive treatment for refractory neuropathic pain secondary to traumatic LSP.