Extended duration pulsed radiofrequency for the management of refractory meralgia paresthetica: a series of five cases

Ghai, Babita; Dhiman, Deepanshu; Loganathan, Sekar

doi:10.3344/kjp.2018.31.3.215

Cited by 18 publications

(13 citation statements)

References 15 publications

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“…In contradistinction, continuous radiofrequency ablation applies enough energy (heat) to destroy the nerve (thermocoagulation and necrosis). The comparison between PRF neuromodulation and continuous radiofrequency radioablation is summarized in Table 3 [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Meralgia Paresthetica: A Case Report With an Update on Anatomy, Pathology, and Therapy

Kesserwani

2021

Cureus

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Meralgia paresthetica, a condition characterized by tingling, numbness, and burning pain in the lateral aspect of the thigh, is caused by compression of the lateral femoral cutaneous nerve. The incidence of meralgia paresthetica increases with obesity and diabetes. The unique anatomy of the nerve that tunnels through the inguinal ligament predisposes it to inflammation, trauma, and entrapment. The pathology of meralgia paresthetica parallels that of entrapment neuropathies but with additional inflammatory overlay in certain instances. The clinical diagnosis is relatively simple due to its unique clinical features. The prognosis is generally excellent, and the treatment is straightforward that includes peripheral nerve blocks, neurectomy, nerve decompression, and pulsed radiofrequency neuromodulation. This current case of meralgia paresthetica highlights the salient clinical symptoms and signs. We have also described the electrophysiological studies of the lateral femoral cutaneous nerve, its anatomical variations, and the associations of meralgia paresthetica with bariatric surgery, critical care patients, tight clothing, pregnancy, and posterior spine surgery. We have also outlined the current treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Meralgia Paresthetica: A Case Report With an Update on Anatomy, Pathology, and Therapy

Kesserwani

2021

Cureus

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“…In the study by Klauser et al ., complete symptom resolution was documented in 75% of patients, while partial resolution was documented in the remaining 25% at 12-month follow-up ( 18 ) . Scarce reports on US-guided ablation techniques, such as alcohol neurolysis and pulsed radiofrequency ablation, have been described in the literature as good treatment options ( 20 , 21 ) .…”

Section: Meralgia Parestheticamentioning

confidence: 99%

Ultrasound-guided injections in pelvic entrapment neuropathies

et al. 2021

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Pelvic entrapment neuropathies represent a group of chronic pain syndromes that significantly impede the quality of life. Peripheral nerve entrapment occurs at specific anatomic locations. There are several causes of pelvic entrapment neuropathies, such as intrinsic nerve abnormality or inflammation with scarring of surrounding tissues, and surgical interventions in the abdomen, pelvis and the lower limbs. Entrapment neuropathies in the pelvic region are not widely recognized, and still tend to be underdiagnosed due to numerous differential diagnoses with overlapping symptoms. However, it is important that entrapment neuropathies are correctly diagnosed, as they can be successfully treated. The lateral femoral cutaneous nerve, ischiadic nerve, genitofemoral nerve, pudendal nerve, ilioinguinal nerve and obturator nerve are the nerves most frequently causing entrapment neuropathies in the pelvic region. Understanding the anatomy as well as nerve motor and sensory functions is essential in recognizing and locating nerve entrapment. The cornerstone of the diagnostic work-up is careful physical examination. Different imaging modalities play an important role in the diagnostic process. Ultrasound is a key modality in the diagnostic work-up of pelvic entraptment neuropathies, and its use has become increasingly widespread in therapeutic procedures. In the article, the authors describe the background of pelvic entrapment neuropathies with special focus on ultrasound-guided injections.

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“…The block area was sterilized with 10% povidone solution and covered with surgical drape. Jelly was applied on the tip of linear probe (7)(8)(9)(10)(11). Probe was covered with transparent sterilised plastic drape.…”

Section: Case Reportmentioning

confidence: 99%

Ultrasound-guided radio frequency ablation of lateral femoral cutaneous nerve in intractable meralgia paresthetica

Agrawal¹,

Gill²,

Rana³

et al. 2021

J. Case Rep. Sci. Images

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Meralgia paresthetica characterised by pain, tingling and numbness in lateral aspect of thigh. A 48 year-old male with 2 years history of left lateral thigh paresthesias and burning pain consistent with meralgia paresthetica was referred to our clinic after failing trials of physical therapy, nonsteroidal anti-inflammatories and neuropathic medications. We performed lateral femoral cutaneous nerve block with corticosteroid, after that patient had good relief for 2 months; however, block provided only temporary relief and patient again started feeling same pain. As this pain was limiting the patient's ability to perform his functions as truck driver, we planned to perform a pulsed radiofrequency treatment of the lateral femoral cutaneous nerve left side under ultrasound guidance. After locating the lateral femoral cutaneous nerve with ultrasound and reproducing the patient's dysesthesia with stimulation, pulsed radiofrequency treatment was performed at 42°C for 120 seconds. The needle was then rotated 180° and an additional cycle of pulsed radiofrequency treatment was performed followed by injection of 0.125 % bupivacaine with 20 mg triamcinolone. At 2 and 4 month follow-up visits, the patient reported excellent pain relief with activity and improved ability to perform his duties. We have also described various aetiologies for meralgia paresthetica and multiple modalities available for the treatment of meralgia paresthetica.

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Extended duration pulsed radiofrequency for the management of refractory meralgia paresthetica: a series of five cases

Cited by 18 publications

References 15 publications

Meralgia Paresthetica: A Case Report With an Update on Anatomy, Pathology, and Therapy

Meralgia Paresthetica: A Case Report With an Update on Anatomy, Pathology, and Therapy

Ultrasound-guided injections in pelvic entrapment neuropathies

Ultrasound-guided radio frequency ablation of lateral femoral cutaneous nerve in intractable meralgia paresthetica

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