![]() Prior to a trial of spinal cord stimulation, she was referred for scrambler therapy. A diagnostic right obturator nerve block with bupivacaine and steroids gave partial relief but also motor paralysis for 24 hours, so she was not considered a good candidate for ablation. Gabapentin at effective doses made her feel overly sedated and “foggy-minded.” She had inadequate benefit from bupropion and nortriptyline prescribed for depression, low-dose naltrexone, celecoxib, or ketorolac. The tumor in the right quadriceps muscle appeared deep, with a second tumor more medial and proximal tumor and less distinct (Figure 1). She denied any saddle anesthesia or urinary or fecal incontinence. ![]() She did report some weakness of her right leg, but was able to ambulate without any assistance and has not had any recent falls. The pain was worse with lying on her right side, and alleviated with putting more weight on her left side when sitting. In the last year, the episodes of right-sided stabbing pain had increased in frequency, and occurred 5-6 times a day with some episodes lasting hours. She reported that the pain felt the exact same in quality and location as when she was found to have schwannomas on her left obturator nerve in 2014 then, she underwent left cryoablation of the schwannoma with significant ongoing relief. This 48-year-old woman with known schwannomatosis since age 40 presented with pain in the right anterior thigh and groin. By nature of its inexpensive minimally invasive methods, scrambler therapy has the potential to be another conservative modality of pain relief for patients with schwannomatosis.Ī preprint of this article was previously published in Research Square. Through repeated treatments, these synthetic signals can potentially cause a type of “retraining” of the brain, leading to a decrease or resolution of the targeted pain. These synthetic signals are transmitted via topical electrical stimulation channels which may interact with the surface receptors of C fibers . Scrambler therapy is believed to be effective by acting on the afferent information aspects of pain, which is accomplished by replacing endogenous pain signals with synthetic signals that travel along the same nervous pathways. Scrambler therapy is a relatively new neuromodulatory treatment approach, which has been shown to provide relief from neuropathic pain . ![]() For schwannomas causing functional limitations, or for patients with refractory pain and/or medication intolerance, surgical resection of the offending lesion remains an effective, albeit more invasive option . Classical conservative management of chronic neuropathic pain associated with schwannomatosis involves neuropathic agents including gabapentin, amitriptyline, and pregabalin. Schwannomatosis is a condition most frequently characterized by the development of multiple schwannomas throughout the body, and the most common presenting complaint is chronic neuropathic pain .
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |