Role of Lumbar Sympathetic MIPSI in Linezolid-induced Peripheral Neuropathy with Motor Dysfunction

Abstract

Abstract Linezolid is a Class A drug of multidrug-resistant and extensively drug-resistant tuberculosis whose use carries a considerable risk of toxicity. In this study, five patients of linezolid-induced peripheral neuropathy (LIPN) showed decreased great toe power in both lower limbs (LLs). The sympathetic nervous system has been implicated in pain and motor dysfunction associated with painful peripheral neuropathy. Therapeutic interventions targeted at the sympathetic nervous system are very uncommon. We have used pain detect score (PDS) for the assessment of neuropathic pain. However, none of the criteria in the PDS questionnaire include motor response, thus in patients with sensory-motor neuropathy, we assessed great toe power, which was 4/5 in all 5 patients before lumbar sympathetic minimally invasive pain and spine intervention (MIPSI). All patients had improved pain symptoms and great toe power 5/5 immediately postprocedure, with no slipping of chappals. Here, we are providing evidence and conclude that lumbar sympathetic MIPSI is an important modality of treatment in patients with LIPN with motor dysfunction.