Spinal cord stimulation markedly ameliorated refractory neuropathic pain in transthyretin Val30Met familial amyloid polyneuropathy

Abstract

Although spinal cord stimulation has been reported to be effective for controlling neuropathic pain in diabetic neuropathy, it has rarely been investigated in other peripheral neuropathies. We describe, for the first time, the efficacy of spinal cord stimulation for refractory neuropathic pain in a patient with transthyretin Val30Met associated familial amyloid polyneuropathy (FAP ATTR Val30Met). A 72-year-old man was diagnosed as having FAP ATTR Val30Met when he was 70 years old. He had been complained of burning pain in the distal portion of his bilateral lower limbs since he was 69 years old. Because conventional symptomatic therapies, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, and tricyclic antidepressants did not ameliorate pain, he underwent bilateral lumbar spinal cord electrical stimulation at high frequency and low voltage at the level of Th12 vertebral body and this was markedly effective. Our case expands the application of spinal cord stimulation, which should be considered as an alternative therapeutic approach for relief of neuropathic pain, which can be extremely distressful for patients and may lead to an impaired quality of life.

Keywords:

• Neuropathic pain
• familial amyloid polyneuropathy
• spinal cord stimulation
• quality of life
• symptomatic therapies

Declaration of interest:

This work was supported by grants from the Ministry of Health, Labor, and Welfare and the Ministry of Education, Culture, Sports, Science, and Technology of Japan. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.