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Final Program


Final Program

Neuromodulation

1508 - Unilateral Peripheral Nerve Stimulation Producing Bilateral Analgesia in Chemotherapy-Induced Neuropathy

Friday, February 20, 2026
5:00 PM - 6:30 PM AST

    Presenting Author(s)

  • AS

    Aslihan P. Sahin, DO

    Resident Physician
    Jefferson Moss-Magee Rehabilitation
    Elkins Park, Pennsylvania, United States

    • Co-Author(s)

  • AM

    Alyssa Marulli, MD

    Attending Physician
    Jefferson Moss-Magee Rehabilitation
    Elkins Park, Pennsylvania, United States

    • Submitter(s)

  • AS

    Aslihan P. Sahin, DO

    Moss Rehab
    Elkins Park, Pennsylvania, United States

Case Diagnosis: Chemotherapy-induced peripheral neuropathy (CIPN)

Case Description: An 85-year-old female with breast cancer presented with burning pain in both feet radiating to the ankles years after receiving chemotherapy. Her workup was negative for other organic causes of neuropathy, and her symptoms were attributed to CIPN. She was treated with Duloxetine and Pregabalin without significant symptom control. She underwent implantation of a peripheral nerve stimulator with the SPRINT® system to the left sciatic nerve. After the procedure, she reported up to 70% pain relief. The nerve stimulator was removed after 60 days. Unfortunately, the patient’s pain returned to baseline approximately 2 months after the removal. She was interested in a permanent peripheral nerve stimulator and underwent implantation of the Stimrouter® device to the left sciatic nerve. After fine tuning of the settings, interestingly, the patient reported significant relief of burning pain in both feet.

Discussions:

Peripheral nerve stimulators are used in chronic pain management as a minimally invasive option for targeted pain relief. With regards to CIPN, the first-line treatment is multimodal pharmacological and physical therapy. If first-line treatments fail, neuromodulation may be considered. Spinal cord or dorsal root ganglion stimulators are preferred in patients with CIPN due to the ability to target broader areas of pain, however peripheral nerve stimulation can be considered in patients whose symptoms are localized to one or two nerve distributions. The mechanism by which implantation of a single peripheral nerve stimulator yielded bilateral symptom relief in our patient remains unclear and not well-characterized in the existing literature. One possible explanation is central neuromodulatory effects, whereby unilateral peripheral stimulation may alter central pain processing pathways and thereby influence contralateral symptoms.

Conclusions: Implantable peripheral nerve stimulators represent a promising therapeutic approach for CIPN; however, further investigation is warranted to establish the efficacy, safety, and optimal application of neurostimulation in this context.