Successful Utilization Of High Frequency Spinal Cord Stimulation For Hiv And Chemotherapy Induced Polyneuropathy

Abstract

We present a case of a 53-year-old male who presented with functionally limiting bilateral lower extremity neuropathic pain secondary to multiple subtypes of small fiber neuropathy. He had failed management with multiple conservative measures including oral medications, physical therapy and desensitization techniques. He ultimately underwent placement of a spinal cord stimulator and continued to experience 80% improvement of his pain, as well as improved function and quality of life at 5 month follow-up. To our knowledge, this is the first reported case of successful treatment of multiple subtypes of small fiber neuropathy with spinal cord stimulator.

Plain language summary

We report a case of a 53-year-old male who presented with multiple subtypes of small fiber neuropathy, characterized by abnormal sensation and nerve pain in his distal lower extremities, which was making performing his activities of daily living challenging. He had failed multiple conservative measures including oral medications, physical therapy and desensitization techniques. The patient then underwent a trial with a spinal cord stimulator, which includes placing a device in the spinal canal that can alleviate pain by providing low levels of electrical current. At the 5 month follow-up, he continued to report 80% improvement of his pain as well as improved function and quality of life. This is the first reported use of spinal cord stimulator in a patient with multiple subtypes of small fiber neuropathy.

Keywords::

• chemotherapy induced neuropathy
• high frequency spinal cord stimulation
• HIV neuropathy
• neuromodulation
• polyneuropathy
• small fiber neuropathy
• spinal cord stimulation

Author contributions

All authors listed on this title page have read the manuscript, attest to the validity and legitimacy of the information, and agree to its submission for publication in Pain Management.

Acknowledgments

The authors would like to thank J Cohen from Memorial Healthcare System, Department of Physical Medicine&Rehabilitation, Division of Pain Medicine, for his expertise and assistance with the implantation of the permanent spinal cord stimulator in our patient.

Financial&competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Informed consent disclosure

The authors state that they have obtained verbal and written informed consent from the patient for the inclusion of his medical and treatment history within this case report.