Ultrasound-Guided Pulsed Radiofrequency in the Anterior Femoral Cutaneous Nerves to Treat Postherpetic Neuralgia in Anteromedial Thigh: A Case Report

TL;DR

A case report shows that pulsed radiofrequency on a specific nerve helped relieve chronic pain from shingles in a patient's thigh.

Contribution

Demonstrates PRF applied to peripheral nerves as a viable treatment for refractory postherpetic neuralgia.

Findings

PRF applied to the anterior femoral cutaneous nerves provided significant pain relief for PHN in the anteromedial thigh.

Targeting peripheral nerves with PRF is a safe and effective alternative for treating localized PHN.

This case suggests a potential expansion of PRF application beyond the dorsal root ganglion for PHN treatment.

Abstract

Postherpetic neuralgia (PHN) is a typical neuropathic pain after the eruption of the herpes zoster (HZ) rash. Pulsed radiofrequency (PRF) represents a minimally invasive, target-selective neuromodulatory intervention for PHN, with the dorsal root ganglion (DRG) serving as its primary therapeutic target. However, there is a paucity of evidence about the application of PRF to target peripheral nerves to treat PHN, which is easier to access with a lower risk of complications. We describe the successful management of a case by using PRF in the anterior femoral cutaneous nerves (AFCNs) to treat PHN in the anteromedial thigh in a 70-year-old male. This report highlights that PRF directed at peripheral nerves could also yield significant pain relief in chronic localized refractory PHN. Targeting peripheral nerves with PRF emerges as a viable treatment strategy for this patient population.

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