BACKGROUND: Neuropathic pain in adrenomyeloneuropathy (AMN) is a poorly understood phenomenon, with no consensus on treatment options. We report for the first time the successful treatment of medication-refractory neuropathic pain in AMN with thoracic spinal cord stimulation (SCS).

CASE REPORT: A 33-year-old man with AMN presented to clinic with a 10-year history of progressive bilateral distal leg pain and numbness, and a diagnosis by electromyoneurography of demyelinating polyneuropathy, refractory to best medical therapy. After a successful percutaneous trial, he underwent insertion of a paddle system spanning T10-T12. At 3 and 12 months, validated questionnaires revealed improved pain and psychosocial functioning.

CONCLUSIONS: We therefore advocate for prompt referral to pain specialists for further workup and management, including consideration of SCS.

KEYWORDS: Adrenomyeloneuropathy, diabetic neuropathy, neuromodulation, neuropathic pain, spinal cord stimulation