Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) often tend to suffer from severe neuropathic pain. Neuropathic agents and opioids have limited success in providing acceptable relief, leaving patients with significant disability and poor quality of life. We present a patient with CIDP, suffering from neuropathic pain with significant improvement of her symptoms during the spinal cord stimulation (SCS) trial period.

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Patient is a 55-year-old, left-handed woman with persistent neuropathic pain in bilateral lower extremities, secondary to CIDP.  Her symptoms were described as numbness, tingling, and electric shock-like pain. She does have diffuse weakness in bilateral lower extremities, more notable distally as well as impaired sensation of light-touch, pin-prick and vibration. Her social life, mood, daily activities, and sleep have been negatively affected by these symptoms.

She has required intensive physical therapy and medical management including high dose gabapentin, antidepressants, and Percocet 40 mg daily in order to achieve decent control of her symptoms. Due to concerns for the amount of medications she required, she was offered treatment with SCS. HF10TMsystem by Nevro was used and the leads were successfully placed at T8 and T9 spinal levels. During the SCS trial she reported 80-90% reduction in her pain in lower extremities.  She also was able to reduce from 3-4 tabs of Percocet to only ½ tab daily.  Overall, significant improvement in her pain control was achieved, resulting in notable improvement in her quality of life. She will proceed with placement of the permanent SCS.

To our knowledge, this is the first time SCS has been utilized in treating neuropathic pain secondary to CIDP, with such promising outcome.  Neuromodulation can be considered as a reasonable modality in treatment of neuropathic pain in inflammatory demyelinating disorders with the tendency to provide significant improvement in symptoms and quality of life.