Scrambler therapy for the treatment of neuropathic pain related to leukemia in a pediatric patient

Abstract

Rationale:Cancer-related neuropathic pain often responds poorly to standard pain treatments. Scrambler therapy has relieved refractory chronic pain in several uncontrolled clinical trials.Patient concerns:An 11-year-old female patient was suffering from left groin and medial thigh pain after irradiation to the knee. The girl was diagnosed with precursor B-cell lymphoblastic leukemia 2 years ago. Extramedullary relapse of leukemia developed 1 month ago and pain had started. She was treated with oral medications, but she was continuously complaining of severe pain.Diagnosis:Neuropathic pain caused by obturator nerve involvement in leukemia.Intervention:Scrambler therapy.Outcome:Pain reduction.Lessons:Scrambler therapy is noninvasive, is not associated with any complications, causes minimal discomfort during treatment, and is very effective in a pediatric patient with cancer-related neuropathic pain.

Scrambler therapy improves pain in neuromyelitis optica

“…The target sample size of 22 (11 per arm) was based on previous studies that suggested that the average pain value at baseline is at least 4 on the 0 to 10 NRS with an SD of the original pain value expected to fall in the range of 1 to 1.5 in this patient population. 11,14,[27][28][29][30] A conservative estimate of the SD of the change across patients from day 1 to 10 was up to ≈2. With 11 patients in each arm and under these assumptions, we were able to detect a change of 2.5 points in the Scrambler group at 80% power, with a difference in proportions of 60% between the 2 groups.…”

“…To date, most research investigating the effect of Scrambler therapy on pain has involved open-label trials for peripheral neuropathic pain management. [12][13][14][15]33,34 Four studies have used a random controlled design, including 2 unblinded prospective randomized trials that tested Scrambler against an active comparator 30,35 and 2 that have applied a blinded randomized sham-controlled design. One involved patients with chemotherapy-induced peripheral neuropathy, which found no difference compared to Scrambler therapy placed on the back near the spine (n = 14).…”

“…11 This neuromodulatory therapy has been investigated for the treatment of persistent peripheral neuropathic pain, largely in open-label observational trials, in several conditions including chemotherapy-induced neuropathy, postherpetic neuralgia, and postsurgical neuropathic pain with promising results. [11][12][13][14][15][16][17] Patients report sustained relief after undergoing daily treatment sessions for 10 consecutive weekdays. 11 Anecdotal evidence supports Scrambler therapy for use in patients with persistent central neuropathic pain, 18,19 but no rigorous studies have systematically tested the benefit or sustainability of Scrambler vs a placebo treatment.…”

Neuropathic Pain in Pediatric Oncology: A Clinical Decision Algorithm

“…There is emerging evidence for the efficacy of scrambler therapy (ST) for chemotherapy related NP in adults [60,61] and in the pediatric population [62,63], based on the fact that ST can block painful stimuli by sending "non-painful" stimuli to the cutaneous nerves. This electro-analgesia device consists of a multiprocessor that can generate non-painful stimuli by application of surface electrodes on skin over the painful areas.…”

Scrambler therapy for the treatment of diabetic peripheral neuropathy pain

“…ST has been shown to relieve refractory chronic pain in several uncontrolled clinical trials: in 11 cancer patients with abdominal pain; [4] in 226 patients with neuropathic pain, including those with failed back surgery syndrome, brachial plexus neuropathy, trigeminal neuralgia, and others; [5] refractory chemotherapy-induced neuropathic pain; a wide spectrum of cancer-related pain; and postherpetic neuropathy, spinal cord stenosis, and failed back syndrome. [6,7] However, to the best of our knowledge, there is no published literature about the use of ST for treating neuropathic pain related to DM.…”