PMCID: PMC6489430 PMID: 31049038
Case Report: Scrambler Therapy for Treatment-Resistant Central Neuropathic Pain in a Patient with Transverse Myelitis
From the Department of Neurology (MAM, SDN, ML) and Department of Oncology (TJS), Johns Hopkins University School of Medicine, Baltimore, MD, USA; and Department of Acute and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD, USA (MAM, SLK).
Correspondence: Thomas J. Smith, MD, Professor of Oncology and the Harry J. Duffey Family Professor of Palliative Medicine, Director of Palliative Medicine, Johns Hopkins Medical Institutions, Johns Hopkins Hospital, 600 N. Wolfe St., Blalock 369, Baltimore, MD 21287-0005, USA; e-mail: ude.imhj@631timst.
Central neuropathic pain is a severely disabling consequence of conditions that cause tissue damage in the central nervous system. It is often refractory to treatments commonly used for peripheral neuropathy. Scrambler therapy is an emerging noninvasive pain-modifying technique that uses transcutaneous electrical stimulation of nociceptive fibers with the intent of reorganizing maladaptive signaling pathways. It has been examined for the treatment of peripheral neuropathy with favorable safety and efficacy outcomes, but its application to central neuropathic pain has not been reported in transverse myelitis. We describe the use of Scrambler therapy in a patient with persistent central neuropathic pain due to transverse myelitis. The patient had tried multiple drugs for treatment of the pain, but they were not effective or caused adverse effects. After a course of Scrambler therapy, pain scores improved considerably more than what was reported with previous pharmacologic and nonpharmacologic interventions. This case supports further investigation of Scrambler therapy in multiple sclerosis, neuromyelitis optica spectrum disorder, and other immune-mediated disorders that damage the central nervous system.
Keywords: Autoimmune disease, Central pain, Demyelinating disease, Multiple sclerosis (MS), Neuropathic pain, Neuromodulation, Scrambler therapy, Transverse myelitis