Wang J, Yu XQ, Zhang XG, Song L, Lee J. Short-term spinal cord stimulation for refractory Elsberg syndrome in diabetic neuropathy: A case report. World J Clin Cases 2025; 13(33): 112607 [PMID: 41356088 DOI: 10.12998/wjcc.v13.i33.112607]
Corresponding Author of This Article
Jun Lee, MD, Professor, Department of Pain Management, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 616400, Sichuan Province, China. leej1981@126.com
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Neurosciences
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Case Report
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Nov 26, 2025 (publication date) through Jan 9, 2026
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World Journal of Clinical Cases
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Wang J, Yu XQ, Zhang XG, Song L, Lee J. Short-term spinal cord stimulation for refractory Elsberg syndrome in diabetic neuropathy: A case report. World J Clin Cases 2025; 13(33): 112607 [PMID: 41356088 DOI: 10.12998/wjcc.v13.i33.112607]
World J Clin Cases. Nov 26, 2025; 13(33): 112607 Published online Nov 26, 2025. doi: 10.12998/wjcc.v13.i33.112607
Short-term spinal cord stimulation for refractory Elsberg syndrome in diabetic neuropathy: A case report
Jia Wang, Xiao-Qian Yu, Xue-Guang Zhang, Li Song, Jun Lee
Jia Wang, Xiao-Qian Yu, Xue-Guang Zhang, Li Song, Jun Lee, Department of Pain Management, West China Hospital, Sichuan University, Chengdu 616400, Sichuan Province, China
Author contributions: Wang J, Yu XQ, and Zhang XG were responsible for data collection; Wang J drafted the manuscript; Yu XQ conducted patient follow-up; Song L and Lee J contributed to manuscript revision and finalized the manuscript. All the authors have read and approved the final manuscript.
Supported by the Science and Technology Department of Sichuan Province, No. 2023YFS0255.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Lee, MD, Professor, Department of Pain Management, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 616400, Sichuan Province, China. leej1981@126.com
Received: August 1, 2025 Revised: August 21, 2025 Accepted: October 28, 2025 Published online: November 26, 2025 Processing time: 112 Days and 18.1 Hours
Abstract
BACKGROUND
Elsberg syndrome is a type of postinfectious lumbosacral radiculitis typically triggered by neurotropic viruses and manifests as bladder/bowel dysfunction, saddle sensory disturbances (including hypoesthesia, hyperesthesia, or dysesthesia), and variable neurological deficits. Typically self-limiting, it often responds to antiviral and neurotropic therapies. However, in patients with comorbidities that confer susceptibility to peripheral neuropathy (e.g., diabetes mellitus), timely escalation to neuromodulation strategies, such as spinal cord stimulation, may be warranted to optimize functional outcomes when conservative measures are inadequate.
CASE SUMMARY
A 60-year-old male with diabetes mellitus presented with severe bladder and bowel dysfunction persisting for more than two months, followed by left gluteal and perianal (saddle area) herpes zoster eruption that was accompanied by significant neuropathic pain. Following a suboptimal response to conservative therapy, the patient underwent implantation of a short-term spinal cord stimulation. Following a 10-day trial of continuous tonic stimulation, the percutaneous electrode lead was removed. The patients experienced no surgical complications, and after the procedure, the patient achieved complete restoration of bladder and bowel function and significant pain alleviation. Two-month follow-up confirmed sustained full recovery.
CONCLUSION
Early implementation of short-term spinal cord stimulation represents a promising therapeutic approach for promoting neurological recovery in patients with Elsberg syndrome refractory to conservative management, especially those with predisposing comorbidities such as diabetes mellitus.
Core Tip: Elsberg syndrome is a type of sacral radiculitis caused by various viruses. We report a rare case of a diabetic patient with refractory Elsberg syndrome secondary to varicella-zoster virus sacral neuropathy. A suboptimal response to conservative therapy was observed, likely compounded by underlying diabetic polyneuropathy, and short-term spinal cord stimulation therapy led to complete neurological recovery and pain resolution, which was sustained at the two-month follow-up.
