梨状肌注射肉毒杆菌毒素治疗顽固性阴部神经痛减压术1例。

IF 1.5 Q4 CLINICAL NEUROLOGY
Tomás Caroço, Renaud Bollens, Diogo Portugal
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引用次数: 0

摘要

阴部神经病变是骨盆疼痛的一个原因,特别是阴部神经痛。阴部神经与感觉、运动和自主神经功能有关。我们提出的情况下,41岁的男子谁遭受慢性盆腔疼痛。患者详细描述了龟头刺痛、阴茎灼痛、直痛、下尿路症状、“肌肉紧张”感和挤压痛。他被诊断为前列腺炎,接着是阴部神经痛。我们的病人接受了抗生素和止痛药治疗,症状没有改善。他随后接受了阴部神经减压手术,部分改善。患者开始了康复计划,并向梨状肌注射了肉毒杆菌毒素(BoNT-A),效果良好。BoNT-A对疼痛缓解的积极作用可能证实了梨状肌压迫阴部神经。BoNT-A也可能减少疼痛通路中神经递质的释放。阴部神经痛的早期识别可以防止发展为慢性疼痛。BoNT-A在手术后阴部神经减压患者中的作用尚未确定。我们的病例证实,应该进行更多的研究来探索BoNT-A在这些患者中的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Botulinum toxin injection of the piriformis muscle for refractory pudendal neuralgia after decompression surgery: case report.

Pudendal neuropathy is a cause of pelvic pain, specifically pudendal neuralgia. The pudendal nerve is related to sensory, motor, and autonomic functions. We present the case of a 41-year-old man who suffered from chronic pelvic pain. In detail, the patient described stinging burning pain in the glans penis, proctalgia, lower urinary tract symptoms, sensation of "muscle tension" and squeezing pain. He was diagnosed with prostatitis and, following, pudendal neuralgia. Our patient was treated with antibiotics and analgesics, without improvement of symptoms. He was then submitted to decompression surgery of the pudendal nerve, with partial improvement. The patient started a rehabilitation program and was treated with OnabotulinumtoxinA (BoNT-A) injections into the piriformis muscle with benefit. BoNT-A positive effects on pain relief may corroborate piriformis muscle compression of the pudendal nerve. BoNT-A may also reduce the release of neurotransmitters from the pain pathways. Early identification of pudendal neuralgia could have prevented the progression to chronic pain. There is still not an established role for BoNT-A in post-operative pudendal nerve decompression patients. Our case corroborates that more studies should be performed to explore BoNT-A administration in these patients.

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来源期刊
Pain management
Pain management CLINICAL NEUROLOGY-
CiteScore
2.90
自引率
5.90%
发文量
62
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