BACKGROUND: Notalgia paresthetica is a sensory neuropathy characterized by severe pruritus, pain, and hyperpigmented patches in the T2-T6 distribution. Despite multiple treatment options, there are no established guidelines to manage this challenging sensory neuropathy.

CASE REPORT: A 64-year-old man presented to the pain clinic with persistent notalgia paresthetica for 5 years. He was unable to tolerate oral neuropathic agents, and insurance coverage for capsaicin cream and botulinum toxin injections was denied. He was treated with suzetrigine, a novel NaV1.8 channel inhibitor, for 1 month and experienced complete resolution of symptoms.

CONCLUSIONS: The etiology of notalgia paresthetica has not been fully elucidated, but it is thought to involve irritation and aberrant firing of the thoracic spinal nerves.

This response to suzetrigine suggests that it may act as a peripheral nerve membrane stabilizer and may be a treatment option for this condition.

KEYWORDS: NaV1.8 inhibitor, Notalgia paresthetica, case report, chronic pain, neuropathy, suzetrigine