I had a spinal cord stimulator (SCS) trial and subsequent removal, but I'm still experiencing sharp intermittent electrical impulses in my head, what could be causing this?

Persistent Electrical Sensations After Spinal Cord Stimulator Trial Removal

You are most likely experiencing residual nerve irritation or inflammation at the lead insertion site, which should resolve spontaneously within days to weeks, though you need immediate neurological evaluation to rule out serious complications like epidural hematoma or spinal cord injury.

Immediate Assessment Required

You need urgent neurological examination to exclude serious complications. While most post-removal sensations are benign, spinal cord stimulation carries risks of neurological injury including:

• Spinal cord compression from epidural hematoma - can present with new neurological symptoms after lead removal and requires emergency imaging 1, 2
• Direct cord injury or contusion - rare but documented complication that may manifest as altered sensations 1
• Subdural hematoma - can occur after dural puncture during lead placement and present with evolving symptoms including headache and unusual sensations 3

Most Likely Explanation

The sharp electrical impulses you're experiencing are most probably due to local tissue irritation and nerve inflammation from the recently removed leads. This is the most common benign explanation:

• Lead placement and removal causes mechanical irritation of nerve roots and surrounding tissues 2
• Percutaneous lead insertion involves direct contact with neural structures that can remain sensitized after removal 4
• These sensations typically resolve as local inflammation subsides over days to weeks 2

Critical Warning Signs Requiring Emergency Evaluation

Seek immediate medical attention if you develop any of these symptoms:

• Progressive weakness in your legs or arms 1
• Loss of bowel or bladder control 1
• Worsening or changing pattern of sensations 3
• Severe headache that differs from typical post-procedure headache 3
• Fever or signs of infection at the insertion site 2

One case series documented 4 patients who developed paraparesis after SCS procedures, with causes including cord contusion and epidural hematomas - all required urgent intervention 1.

Expected Timeline and Management

If serious complications are ruled out, expect gradual improvement over 1-4 weeks:

• Local nerve irritation typically resolves as tissue healing progresses 2
• The electrical sensations should gradually decrease in frequency and intensity 2
• Complete resolution may take several weeks as inflammation fully subsides 2

Conservative management while symptoms resolve:

• Neuropathic pain medications (gabapentin, pregabalin) may help reduce the electrical sensations if bothersome 5, 6
• Anti-inflammatory medications can address local tissue inflammation 6
• Avoid activities that exacerbate symptoms during the healing period 2

Common Pitfall to Avoid

Do not dismiss evolving or worsening symptoms as "normal post-procedure effects." Change in the character of initial symptoms may signal onset of a secondary complication rather than resolution 3. The key distinction is that benign post-removal sensations should steadily improve, not worsen or change in character over time.

Follow-Up Recommendation

Contact your implanting physician within 24-48 hours to report these symptoms. They need to:

• Perform focused neurological examination 1
• Consider imaging (MRI or CT) if symptoms are concerning or not improving 3
• Document the timeline and character of your symptoms for monitoring 2

While infection rates of 10-29% are reported with SCS procedures 5, 2, most complications manifest during the implanted period rather than after removal, making your symptoms more likely related to tissue healing than active infection.