Chronic idiopathic axonal neuropathy and pain, treated with the endogenous lipid mediator palmitoylethanolamide: a case collection
A 73-year-old Caucasian female (born in 1941) suffering from burning pains since 2003 was diagnosed with sensory axonal neuropathy as confirmed by EMG in 2003. Pain scores when we first saw her in 2011 were 8 out of 10 on the NRS. TENS (transcutaneous electrical nerve stimulation) and amitriptyline 30 mg before sleep did not result in pain reduction, tramadol 100 mg bid did help to bring down peak pain effects. Treatment was started using 1200 mg PEA per day, and this reduced the burning pain from NRS score 8 to 6. The patient stopped tramadol, and this resulted in a relapse of pain. Tramadol was reinitiated, and PEA dose was increased to 2000 mg daily. Pain intensity decreased, and within 14 days, all burning sensations vanished; the patient spoke of “a miracle.” The situation remained stable for months, and side effects were not reported.