title: [Cluneal inferior neuralgia by conflict around the ischium: Identification of a clinical entity from a series of anesthetic blocks in 72 patients].
abstract: BACKGROUND
  Some patients have atypical perineal neuropathic pain that differs from a pudendal neuralgia. The purpose of this study was to define a new clinical entity of such pain and to evaluate the therapeutic benefit of corticosteroid infiltration.
  
  
  METHODS
  Retrospective study of 72 patients presenting with atypical perineal pain. A nerve block was performed using added steroid anesthetic in cluneal inferior nerve, at the endo-ischial area. Pain assessment was recorded 8 days and 10 minutes before the injection and 5 minutes and 3 weeks after the procedure.
  
  
  RESULTS
  The population included 40 (55%) women, mean age 55. Forty-nine (68%) patients presented with a positive block test. These patients were characterized by ischio-perineal neuropathic pain, respecting the penis or clitoris, worse sitting (98%), especially on hard seats, do not wake up at night, and not accompanied by superficial hypoesthesia. A decrease in VAS scores (>30%) at 23 weeks follow-up following the addition of corticosteroids during infiltration was observed in only 29 (40%) patients.
  
  
  CONCLUSIONS
  The current series described the population characteristics of cluneal inferior neuralgia by ischial conflict.
authors.affiliation: Centre régional de rééducation et de réadaptation fonctionnelle, rue des Capucins, BP 40329, 49103 Angers cedex 02, France. uriell.pouliquen@yahoo.fr
authors.forename: U
authors.initials: U
authors.lastname: Pouliquen
authors.forename: T
authors.initials: T
authors.lastname: Riant
authors.forename: R
authors.initials: R
authors.lastname: Robert
authors.forename: J-J
authors.initials: JJ
authors.lastname: Labat
mesh_terms: D005260:Female; D006801:Humans; D007512:Ischium; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D009437:Neuralgia / Q000175:diagnosis* / Q000209:etiology*; D010502:Perineum / Q000294:innervation*; D060545:Pudendal Neuralgia / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies