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CASE REPORT
Year : 2015  |  Volume : 1  |  Issue : 1  |  Page : 28-30

The diagnostic dilemma of a genitofemoral-ilioinguinal overlap syndrome


1 Lead Consultant and Director, Department of Neurology; Pain Services, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
2 Director, Department of Pain Medicine, Daradia Pain Clinic, Kolkata, West Bengal, India

Correspondence Address:
Pravin Thomas
Lead Consultant Department of Neurology; Director, Pain Services, Believers Church Medical College Hospital, Thiruvalla, Kerala-689103
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10046-0009

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Background: It is sometimes difficult to clinically delineate genitofemoral and ilioinguinal neuralgias because of the overlap in the clinical symptomatology. Case description: A young male with a past history of transurethral removal of ureteral calculi presented with severe, debilitating neuropathic pain in the groin. He had hyperpathia and allodynia in the distribution of genitofemoral nerve, and hence a clinical diagnosis of genitofemoral neuralgia was made. An ultrasound guided diagnostic block of the genitofemoral nerve with local anesthetic produced only a mild reduction in pain (VAS 2 reduction). A repeat diagnostic block of the ilioinguinal nerve produced complete resolution of pain. Literature search showed a limited number of case reports of ultrasound guided blocks for genitofemoral neuralgia; and overlap syndromes have been addressed with differential nerve blocks. Clinical relevance: Our hypothesis is that an aberrant reinnervation from the ilioinguinal to genitofemoral nerve may present with features favoring a genitofemoral neuralgia. In situations where radiofrequency treatment is being considered, such cases may pose a failed intervention if both nerves are not separately targeted.


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