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Int J MS Care. 2019 Mar-Apr;21(2):76-80. doi: 10.7224/1537-2073.2017-083.

Case Report: Scrambler Therapy for Treatment-Resistant Central Neuropathic Pain in a Patient with Transverse Myelitis.


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.


Autoimmune disease; Central pain; Demyelinating disease; Multiple sclerosis (MS); Neuromodulation; Neuropathic pain; Scrambler therapy; Transverse myelitis

Conflict of interest statement

Ms. Mealy receives training funded in part by grant TL1 TR001078 from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health (NIH), and by NIH Roadmap for Medical Research. Dr. Newsome receives research support from Biogen, Genentech, the Department of Defense, the National MS Society, and the Patient-Centered Outcomes Research Institute and has received personal compensation for consultation with Biogen, Genentech, Celgene, EMD Serono, Syntimmune, and Gerson Lehrman Group. Dr. Kozachik receives research support from the NIH Pain Consortium and the Maryland Higher Education Commission. Dr. Levy currently receives research support from the NIH, Maryland Technology Development Corporation, Sanofi, Genzyme, Alexion, Alnylam, Shire, Acorda, and ApoPharma; has received personal compensation for consultation with Alexion, Acorda, and Genzyme; and serves on the scientific advisory boards for Alexion, Acorda, and Quest Diagnostics. Dr. Smith receives research support from the National Cancer Institute (NCI) core grant to the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center (an RO1-funded study of early vs late palliative care for patients on phase I studies), the Avon Foundation, the Milbank Fund, and a Patient-Centered Outcomes Research Institute grant to study preoperative and postoperative palliative care for patients undergoing major surgery. Dr. Smith also received travel funds to teach at a conference in Seoul, Korea, sponsored by GEOMC Inc, the maker of Scrambler.

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