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Purpose: Transverse myelitis (TM)-associated dysesthesia is diverse and frequently resistant to treatment. This study explored the comprehensive effects of a novel transcutaneous electrical nerve stimulation (TENS) approach tailored to an individual's specific dysesthesia profile in a patient with TM., Patient and Method: A 52-year-old woman with severe dysesthesias in the left C8 sensory area caused by TM underwent an A-B-A-B-A design intervention. The baseline (phase A) and intervention (phase B) phases were both 7 days. Tingling and allodynia were scored on an 11-point numerical rating scale pre-, post-, and 1 h post-treatment. Upper limb activities during daily living were assessed using a wrist-worn accelerometer. The intervention phase consisted of 60-min sessions of TENS two times daily. Furthermore, the intervention and carry-over effects of TENS were evaluated using Tau-U and Bayesian unknown change point models., Results: The effects of TENS resulted in the immediate improvement in tingling, allodynia, and upper limb activity. Long-term effects of TENS affected tingling and upper limb activity; however, no impacts on allodynia were observed., Conclusion: This novel TENS approach shows promise as an effective treatment, even in rare and treatment-resistant dysesthesia associated with TM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Nishi, Ikuno, Minamikawa, Osumi and Morioka.)

Background: Current therapeutic interventions for dysesthesias caused by spinal cord dysfunctions are ineffective. We propose a novel intervention using transcutaneous electrical nerve stimulation (TENS) for dysesthesias, and we present an in-depth case series., Patients and Methods: Conventional high-frequency TENS and the novel dysesthesia-matched TENS (DM-TENS) were applied to 16 hands of nine patients with spinal cord dysfunction. The dysesthesia-matched TENS' stimulus intensity and frequency matched the intensity and somatosensory profile of the patients' dysesthesias. The Short-Form McGill Pain Questionnaire version-2 (SF-MPQ2) and quantitative sensory testing (QST) were applied during electrical stimulation/no stimulation. We determined intraclass correlation coefficients (ICCs) to evaluate the reliability of the setting and the effects on the dysesthesias and the change in subjective dysesthesia between each patient's baseline without TENS and DM-TENS., Results: We were able to apply electrical stimulation matching the patients' subjective dysesthesia for 14 hands (eight patients). TENS could not be applied for the remaining patient due to severe sensory deficits. Compared to the patients' baseline and high-frequency TENS, the DM-TENS provided significant decreases in tingling/pins-and-needles and numbness on the SF-MPQ2, and it significantly improved the dynamic and static mechanical detection on QST. Regarding the reliability of the dysesthesia-matched TENS settings, the ICCs (1,5) were intensity, 0.95; frequency, 1.00; and effect on dysesthesia, 0.98., Conclusion: DM-TENS improved the dysesthesias and mechanical hypoesthesia caused by spinal cord dysfunction. The effectiveness of DM-TENS particularly for tingling and numbness was clearly higher and was reliable within the patients. These results may suggest an effective treatment of dysesthesias in patients with spinal cord dysfunction., Clinical Trial Registration: [https://rctportal.niph.go.jp/s/detail/um?trial_id=UMIN000045332], identifier [UMIN000045332]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Nishi, Ikuno, Minamikawa, Igawa, Osumi and Morioka.)