Recently, Calmare device (i.e., MC5-A Scrambler Therapy) that has already been approved by the Food and Drug Administration for noninvasive treatment of chronic neuropathic and oncologic pain has been found to significantly reduce pain in refractory CIPN also without any evidence of toxicity. The gravity of clinical situation is amplified further if the symptoms of CIPN are refractory to the pharmacological agents. Of all these agents, only duloxetine has been recommended for clinical practice in patients with painful CIPN. Various pharmacological agents like amitriptyline, nortriptyline, topical baclofen-amitriptyline-ketamine gel, lamotrigine, gabapentin, pregabalin, venlafaxine, and duloxetine with variable success rates have been tried for the management of CIPN. The symptoms may either resolve after the completion of therapy or may persist forever due to irreversible neuronal damage. The symptoms of CIPN not only reduce the quality of patient's life but may also lead to discontinuation of anticancer chemotherapy. These symptoms may begin weeks to months after the initiation of treatment and may reach a peak during or after the completion of treatment. The most frequent clinical presentation of CIPN is sensory neuropathy characterized by pain and paraesthesia starting from fingers or toes which spread proximally in “glove and stocking” distribution. Various chemotherapeutic agents including taxanes, platinum compounds, vinca alkaloids, immunomodulatory agents, and proteasome inhibitor have been implicated in the causation of CIPN. Available from: Ĭhemotherapy-induced peripheral neuropathy (CIPN) is a distressing adverse effect that has been reported in up to 68% of patients after the administration of different classes of chemotherapeutic agents. Scrambler therapy: A ray of hope for refractory chemotherapy-induced peripheral neuropathy. How to cite this URL: Ahuja D, Bharati SJ, Gupta N, Kumar V, Bhatnagar S. How to cite this article: Ahuja D, Bharati SJ, Gupta N, Kumar V, Bhatnagar S. Keywords: Chemotherapy-induced peripheral neuropathy, pharmacological management, refractory We have described here successful use of scrambler therapy in three cases of chemotherapy-induced peripheral neuropathy. Chronic neuropathic pain presents a therapeutic challenge if resistant to pharmacological management opioids and other types of treatments. Chemotherapy-induced peripheral neuropathy can markedly deteriorate patient's quality of life and can also negatively affect compliance with the anticancer treatment. The principle with Scrambler Therapy is that synthetic “non-pain” information is transmitted by C fiber surface receptors. Scrambler therapy (ST) is a novel noninvasive modality for treatment of chronic neuropathic and cancer pain using 5 artificial neurons.
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