title: Treatment of human immunodeficiency virus-related peripheral neuropathy with Scrambler Therapy: a case report.
abstract: Peripheral neuropathy is one of the most common neurological complications of HIV infection with a 30-60% lifetime prevalence. Newer HIV drugs cause less peripheral neuropathy, but patients are now living long enough to develop concomitant diabetes-related, vascular-related, and chemotherapy-related neuropathy so it continues as a major debilitating issue. Recent national CDC guidelines have stressed the importance of non-opioid therapies, especially in this population that may have had drug abuse problems. We treated a 52-year-old man who had severe disabling classic peripheral neuropathy since 1998 with Scrambler Therapy (Calmare), an FDA-cleared peripheral non-invasive neuromodulation device. His pain rapidly improved, as did his motor and sensory function, with just four 45-min treatments, and he was able to come off opioids for the first time in years. When his pain returned six months later, only two treatments were needed to resolve it. This represents the first published use of this novel, inexpensive, and non-invasive pain modality in HIV peripheral neuropathy, and should engender further trials.
authors.affiliation: 1 From the Harry J. Duffey Family Palliative Care Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
authors.affiliation: 2 Division of Infectious Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Auwaerter
authors.affiliation: 3 Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Knowlton
authors.affiliation: 4 Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Deanna
authors.initials: D
authors.lastname: Saylor
authors.affiliation: 4 Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: McArthur
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000628:therapy* / Q000821:virology*; D016896:Treatment Outcome
keywords: HIV-associated neuropathy; neuromodulation; neuropathic pain; scrambler therapy