[Cluneal inferior neuralgia by conflict around the ischium: Identification of a clinical entity from a series of anesthetic blocks in 72 patients].

INTRODUCTION

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.

MATERIAL AND 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.

CONCLUSION

The current series described the population characteristics of cluneal inferior neuralgia by ischial conflict.