scholarly journals Ultrasound-Guided Alcohol Neurolysis For Treatment of Refractory Radial Neuralgia

2021 ◽  
pp. 59-62
Author(s):  
Mercy Udoji
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Radial Nerve ◽  
Medication Management ◽  
Traumatic Injury ◽  
Ultrasound Guided ◽  
Surgical Interventions ◽  
Therapeutic Modalities ◽  
First Case ◽  
Upper Extremity Injury

Background: The radial nerve is especially vulnerable to injury due to its location near the humerus. When acute pain becomes chronic and surgical repair is no longer an option, it is necessary to have non-opioid, nonpharmacological methods of pain relief. Case Report: A 63-year-old man presented with severe radial nerve neuralgia secondary to traumatic left upper extremity injury 40 years ago. After several unsuccessful surgical interventions and failing medication management, he was sent to pain management as a last resort prior to elective amputation of the left upper limb. After initial evaluation, the patient underwent a diagnostic ultrasound-guided radial nerve block at the midhumeral level with complete but short-lasting relief of his pain. Shortly after, we performed ultrasoundguided alcohol neurolysis of the radial nerve at the same level. This treatment resulted in 100% pain relief for 10 months with gradual resumption of pain to previous levels at 12 months post neurolysis. Conclusion: Alcohol neurolysis is an effective and viable option for the treatment of neuralgia resistant to other therapeutic modalities. To our knowledge, this is the first case report that describes the use of ultrasound to perform chemical neurolysis of the radial nerve. Key words: Alcohol neurolysis, chronic pain, nerve ablation, neuralgia, neurolysis, opioids, radial nerve, traumatic injury, ultrasound

scholarly journals Successful Treatment of Genitofemoral Neuralgia Using Ultrasound Guided Injection: A Case Report and Short Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Harsha Shanthanna
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Groin Pain ◽  
Case Reports ◽  
Young Male ◽  
Short Review ◽  
Therapeutic Procedure ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Genitofemoral Nerve

A young male patient developed chronic, severe, and disabling right sided groin pain following resection of his left testicular cancer. Since there is considerable overlap, ultrasound guided, selective diagnostic nerve blocks were done for ilioinguinal, iliohypogastric, and genitofemoral nerves, to determine the involved nerve territory. It was revealed that genitofemoral neuralgia was the likely cause. As a therapeutic procedure, it was injected with local anesthetic and steroid using ultrasound guidance. The initial injection led to pain relief of 3 months. Subsequent blocks reinforced the existing analgesia and were sufficient to allow for maintenance with the use of analgesic medications. This case report describes the successful use of diagnostic selective nerve blocks for the assessment of groin pain, subsequent to which an ultrasound guided therapeutic injection of genitofemoral nerve led to long term pain relief. As a therapeutic procedure, genitofemoral nerve block is done in patients with genitofemoral neuralgia. Ultrasound allows for controlled administration and greatly enhances the technical ability to perform precise localization and injection. There are very few case reports of such a treatment in the published literature. Apart from the case report, we also highlight the relevant anatomy and a brief review of genitofemoral neuralgia and its treatment.

scholarly journals Trigeminal neuralgia induced by brainstem infarction treated with pontine descending tractotomy: illustrative case

2021 ◽  
Vol 1 (26) ◽  
Author(s):  
Rachyl M. Shanker ◽  
Miri Kim ◽  
Chloe Verducci ◽  
Elhaum G. Rezaii ◽  
Kerry Steed ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Small Vessel Disease ◽  
Illustrative Case ◽  
Neurovascular Compression ◽  
Ischemic Lesion ◽  
Surgical Interventions ◽  
Brainstem Lesions ◽  
First Case

BACKGROUND While cases of trigeminal neuralgia induced by a brainstem infarct have been reported, the neurosurgical literature lacks clear treatment recommendations in this subpopulation. OBSERVATIONS The authors present the first case report of infarct-related trigeminal neuralgia treated with pontine descending tractotomy that resulted in durable pain relief after multiple failed surgical interventions, including previous microvascular decompressions and stereotactic radiosurgery. A neuronavigated pontine descending tractotomy of the spinal trigeminal tract was performed and resulted in successful pain relief for a 50-month follow-up period. LESSONS While many cases of ischemic brainstem lesions are caused by acute stroke, the authors assert that cerebral small vessel disease also plays a role in certain cases and that the relationship between these chronic ischemic brainstem lesions and trigeminal neuralgia is more likely to be overlooked. Furthermore, neurovascular compression may obscure the causative mechanism of infarct-related trigeminal neuralgia, leading to unsuccessful decompressive surgeries in cases in which neurovascular compression may be noncontributory to pain symptomatology. Pontine descending tractotomy may be beneficial in select patients and can be performed either alone or concurrently with microvascular decompression in cases in which the interplay between ischemic lesion and neurovascular compression in the pathophysiology of disease is not clear.

Ultrasound-Guided Percutaneous Electrical Nerve Stimulation of the Radial Nerve for a Patient With Lateral Elbow Pain: A Case Report With a 2-Year Follow-up

2019 ◽  
Vol 49 (5) ◽  
pp. 347-354 ◽  
Author(s):  
José L. Arias-Buría ◽  
Joshua A. Cleland ◽  
Youssef R. El Bachiri ◽  
Gustavo Plaza-Manzano ◽  
César Fernández-de-las-Peñas
Keyword(s):  
Case Report ◽  
Nerve Stimulation ◽  
Radial Nerve ◽  
Ultrasound Guided ◽  
Elbow Pain ◽  
Electrical Nerve Stimulation ◽  
Lateral Elbow Pain ◽  
Lateral Elbow ◽  
Stimulation Of

Efficacy of Ultrasound-Guided Pulsed Radiofrequency for Recalcitrant Metatarsalgia

2018 ◽  
Vol 108 (6) ◽  
pp. 532-534
Author(s):  
Tsung-Yen Ho ◽  
Ming-Jen Ke ◽  
Liang-Cheng Chen ◽  
Yung-Tsan Wu
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Adhesive Capsulitis ◽  
Tarsal Tunnel ◽  
Pulsed Radiofrequency ◽  
Ultrasound Guided ◽  
First Case ◽  
Patient Reported ◽  
Tunnel Syndrome

Metatarsalgia is characterized by pain in the forefoot, which is associated with increased stress over the metatarsal head region. Despite the availability of a variety of conservative or surgical treatments for this condition, a few cases have demonstrated relapse or poor response to treatment. Pulsed radiofrequency (PRF) can provide pain relief in patients with diverse chronic conditions without causing neural injury. Recently, studies have shown that ultrasound-guided PRF may be beneficial for adhesive capsulitis, carpal tunnel syndrome, tarsal tunnel syndrome, and recalcitrant plantar fasciitis. Here, we describe a successful case of significant pain relief achieved by using ultrasound-guided PRF targeting the posterior tibial nerve (PTN) at the ankle of a 67-year-old woman with recalcitrant metatarsalgia. Ten minutes after ultrasound-guided PRF was applied at the PTN, the patient reported decreased pain (from 8 to 3 on a visual analogue scale) and did not exhibit any particular side effects. Three months after PRF application, the patient's visual analogue scale score remained more than 50% below the baseline, and she did not need additional conservative treatment during the follow-up period. To the best of our knowledge, we present the first case report using ultrasound-guided PRF at the PTN for treatment of recalcitrant metatarsalgia. We hypothesize that ultrasound-guided PRF at the PTN may be a potentially novel approach for treating recalcitrant metatarsalgia.

The first case report of Pembrolizumab inducing thyroiditis and hypophysitis

2020 ◽  
Author(s):  
Rahman Maraqa Sima Abdel ◽  
Robert McMahon ◽  
Anusha Pinjala ◽  
Gastelum Alheli Arce ◽  
Mohsen Zena
Keyword(s):  
Case Report ◽  
First Case

Harel-Yoon syndrome: the first case report from Saudi Arabia

2020 ◽  
pp. 22-27 ◽  
Author(s):  
Alaa AlAyed ◽  
Manar Samman ◽  
Abdul Peer-Zada ◽  
Mohammed Almannai
Keyword(s):  
Saudi Arabia ◽  
Case Report ◽  
First Case
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