Anaesthesiology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
Anaesthesiology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India.
BMJ Case Rep. 2020 Nov 3;13(11):e237864. doi: 10.1136/bcr-2020-237864.
Bernhardt-Roth syndrome (BRS) is a neurological condition characterised by pain, burning or numbness in anterolateral thigh due to entrapment of the lateral femoral cutaneous nerve (LFCN). The possible aetiologies can be mechanical, iatrogenic, neuropathic or idiopathic. After consent for possible publication, we are discussing a case of pain management in a 38-year-old patient with BRS secondary to diabetes. The coherent history, uncontrolled glycaemic status and reduced nerve conduction velocity for LFCN helped reach the diagnosis. Initial treatment with pharmacotherapy, steroid LFCN block and conventional pulsed radiofrequency (PRF) provided moderate temporary pain relief. Extended PRF over 8 min provided significant analgesia without any complications. Physical therapy, adequate glycaemic control and extended PRF provided complete pain relief and improved function over 6 months of follow-up duration. Hence, a cautious multifaceted approach targeting the basic aetiology with extended PRF helped achieve significant analgesia in our refractory case of BRS.
伯纳德-罗特综合征(BRS)是一种神经系统疾病,其特征为大腿前外侧疼痛、烧灼感或麻木,这是由于股外侧皮神经(LFCN)受压所致。可能的病因包括机械性、医源性、神经性或特发性。在征得可能发表的同意后,我们正在讨论一例糖尿病继发 BRS 患者的疼痛管理病例。连贯的病史、血糖控制不佳和 LFCN 神经传导速度降低有助于做出诊断。最初的药物治疗、皮质类固醇 LFCN 阻滞和传统的脉冲射频(PRF)治疗提供了中度的暂时疼痛缓解。8 分钟以上的延长 PRF 治疗提供了显著的镇痛效果,没有任何并发症。6 个月的随访期间,物理治疗、良好的血糖控制和延长 PRF 治疗提供了完全的疼痛缓解和功能改善。因此,针对基本病因的谨慎多方面方法,联合延长 PRF 治疗,有助于在我们的难治性 BRS 病例中实现显著的镇痛效果。