DOI QR코드

DOI QR Code

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

  • Ghai, Babita (Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research) ;
  • Dhiman, Deepanshu (Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research) ;
  • Loganathan, Sekar (Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research)
  • Received : 2018.03.30
  • Accepted : 2018.06.14
  • Published : 2018.07.01

Abstract

Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femoral cutaneous nerve (LFCN) of thigh. Patients refractory to conservative management are treated with various interventional procedures. We report the first use of extended duration (8 minutes) pulsed radiofrequency of the LFCN in a case series of five patients with refractory MP. Four patients had follow up for 1-2 years, and one had 6 months follow up. All patients reported remarkable and long lasting symptom relief and an increase in daily life activities. Three patients came off medications and two patients required minimal doses of neuropathic medications. No complications were observed.

Keywords

References

  1. Cheatham SW, Kolber MJ, Salamh PA. Meralgia paresthetica: a review of the literature. Int J Sports Phys Ther 2013; 8: 883-93.
  2. Patijn J, Mekhail N, Hayek S, Lataster A, van Kleef M, Van Zundert J. Meralgia Paresthetica. Pain Pract 2011; 11: 302-8. https://doi.org/10.1111/j.1533-2500.2011.00458.x
  3. Chen CK, Phui VE, Saman MA. Alcohol neurolysis of lateral femoral cutaneous nerve for recurrent meralgia paresthetica. Agri 2012; 24: 42-4. https://doi.org/10.5505/agri.2012.47450
  4. de Ruiter GC, Wurzer JA, Kloet A. Decision making in the surgical treatment of meralgia paresthetica: neurolysis versus neurectomy. Acta Neurochir (Wien) 2012; 154: 1765-72. https://doi.org/10.1007/s00701-012-1431-0
  5. Lee JJ, Sohn JH, Choi HJ, Yang JS, Lee KH, Do HJ, et al. Clinical efficacy of pulsed radiofrequency neuromodulation for intractable meralgia paresthetica. Pain Physician 2016; 19: 173-9.
  6. Khalil N, Nicotra A, Rakowicz W. Treatment for meralgia paraesthetica. Cochrane Database Syst Rev 2008: CD004159.
  7. Van Zundert J, Brabant S, Van de Kelft E, Vercruyssen A, Van Buyten JP. Pulsed radiofrequency treatment of the Gasserian ganglion in patients with idiopathic trigeminal neuralgia. Pain 2003; 104: 449-52. https://doi.org/10.1016/S0304-3959(03)00066-6
  8. Erdine S, Ozyalcin NS, Cimen A, Celik M, Talu GK, Disci R. Comparison of pulsed radiofrequency with conventional radiofrequency in the treatment of idiopathic trigeminal neuralgia. Eur J Pain 2007; 11: 309-13. https://doi.org/10.1016/j.ejpain.2006.04.001
  9. Thapa D, Ahuja V, Dass C, Verma P. Management of refractory trigeminal neuralgia using extended duration pulsed radiofrequency application. Pain Physician 2015; 18: E433-5.
  10. Akbas M, Luleci N, Dere K, Luleci E, Ozdemir U, Toman H. Efficacy of pulsed radiofrequency treatment on the saphenous nerve in patients with chronic knee pain. J Back Musculoskeletal Rehabil 2011; 24: 77-82. https://doi.org/10.3233/BMR-2011-0277
  11. Ahmed A. Prolonged pulsed radiofrequency ablation of genicular nerves of knee for intractable pain from knee osteoarthritis: a case report. J Pain Relief 2016; 5: 265.
  12. Chua NH, Halim W, Beems T, Vissers KC. Pulsed radiofrequency treatment for trigeminal neuralgia. Anesth Pain Med 2012; 1: 257-61. https://doi.org/10.5812/aapm.3493
  13. Philip CN, Candido KD, Joseph NJ, Crystal GJ. Successful treatment of meralgia paresthetica with pulsed radiofrequency of the lateral femoral cutaneous nerve. Pain Physician 2009; 12: 881-5.
  14. Choi HJ, Choi SK, Kim TS, Lim YJ. Pulsed radiofrequency neuromodulation treatment on the lateral femoral cutaneous nerve for the treatment of meralgia paresthetica. J Korean Neurosurg Soc 2011; 50: 151-3. https://doi.org/10.3340/jkns.2011.50.2.151
  15. Ramzy EA, Khalil KI, Nour EM, Hamed MF, Taha MA. Evaluation of the effect of duration on the efficacy of pulsed radiofrequency in an animal model of neuropathic pain. Pain Physician 2018; 21: 191-8.
  16. Ahmed A, Arora D, Kochhar AK. Ultrasound-guided alcohol neurolysis of lateral femoral cutaneous nerve for intractable meralgia paresthetica: a case series. Br J Pain 2016; 10: 232-7. https://doi.org/10.1177/2049463716668811

Cited by

  1. Extra-spinal sciatica and sciatica mimics: a scoping review vol.33, pp.4, 2020, https://doi.org/10.3344/kjp.2020.33.4.305
  2. Extended pulsed radiofrequency as a part of multimodal pain management in a refractory case of Bernhardt-Roth syndrome vol.13, pp.11, 2018, https://doi.org/10.1136/bcr-2020-237864
  3. Meralgia paresthetica caused by inguinal lymphadenopathy related to tinea pedis infection: A case report vol.66, pp.4, 2018, https://doi.org/10.5606/tftrd.2020.4459