title: Ultrasound-guided alcohol neurolysis of lateral femoral cutaneous nerve for intractable meralgia paresthetica: a case series.
abstract: Meralgia paresthetica is a rare sensory entrapment neuropathy which leads to burning, tingling and numbness in the antero-lateral aspect of thigh. Mostly it runs a benign course, and responds to conservative measures. We present a case series of six patients with intractablemeralgiaparesthetica with severe pain over antero-lateral thigh along the distribution of lateral cutaneous nerve of thigh which was further confirmed by nerve conduction study. These patients did not respond to the oral anti-neuropathic medications. The two successive diagnostic lateral femoral cutaneous nerve blocknot onlyhad confirmed the diagnosis but also provided pain relief for a few days. Then the ultrasound-guided lateral femoral cutaneous nerve neurolysis was done using 50% alcohol. In all the patients, there were more than 50% decrease in pain intensity and improvement in quality of life after the procedure, and the relief and improvement were maintained for up to 12 weeks. This case series shows ultrasound-guided lateral femoral cutaneous nerve neurolysis is a safe and effective treatment for intractable meralgia paresthetica and also provides prolonged pain relief and is a good option in avoiding the surgery.Summary pointsThe literature on neurolysis is rare, with only few case reports. This is the first case series on this topic, and it will greatly improve the evidence that ultrasound-guided neurolysis can also be used for intractable meralgia paresthetica patients who do not respond to conservative measures before proceeding to surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asian Institute of Medical Sciences, Faridabad, India.
authors.forename: Arif
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asian Institute of Medical Sciences, Faridabad, India.
authors.forename: Divesh
authors.initials: D
authors.lastname: Arora
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asian Institute of Medical Sciences, Faridabad, India.
authors.forename: Amit Kumar
authors.initials: AK
authors.lastname: Kochhar
keywords: Meralgia paresthetica; alcohol neurolysis; lateral femoral cutaneous nerve