Acute scrotal pain from idiopathic ilioinguinal neuropathy: diagnosis and treatment with EMG-guided nerve block.
Ilioinguinal nerve entrapment presents with a clinical triad of pain in the iliac fossa and inguinal region, sensory abnormalities in the cutaneous distribution of the nerve and tenderness on palpation 2-3 cm medial and below the anterior superior iliac spine. The syndrome poses diagnostic difficulties, as genitofemoral nerve entrapment and non-neurological conditions of the lower abdomen may cause similar pain. We report on a patient with acute groin pain radiating towards the scrotum, caused by ilioinguinal nerve entrapment. The clinical diagnosis was strongly suggested by electromyographic examination, using the monopolar needle as a deep stimulating electrode. Subsequent nerve blockade caused complete relief of symptoms. The technique is described. Future applications for treatment of post-surgical pain are discussed.
ter Meulen
B C
BC
Departments of Neurology and Neurophysiology, Haga-Ziekenhuis, The Hague, The Netherlands. b.termeulen@erasmusmc.nl <b.termeulen@erasmusmc.nl>
Peters
E W
EW
Wijsmuller
A
A
Kropman
R F
RF
Mosch
A
A
Tavy
D L J
DL
D000328:Adult; D004567:Electrodes, Implanted; D004576:Electromyography; D005832:Genital Diseases, Male / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007264:Inguinal Canal / Q000294:innervation*; D007267:Injections; D008012:Lidocaine; D008297:Male; D008775:Methylprednisolone; D009407:Nerve Block; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000628:therapy; D009437:Neuralgia / Q000175:diagnosis* / Q000628:therapy; D009460:Neurologic Examination; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000628:therapy; D012611:Scrotum / Q000294:innervation*
D008012:Lidocaine; D008775:Methylprednisolone