Surgical treatment of the atypical variant of Bernhardt—Roth syndrome (case report and review)
https://doi.org/10.17650/1683-3295-2020-22-2-79-82
Abstract
The objective is to describe an atypical case ofBernhardt-Roth syndrome, manifested without paresthesia and hypesthesia in the zone of innervation of the lateral femoral cutaneous nerve and accompanied by an intermittent limp and to demonstrate the effectiveness of surgical treatment of an atypical variant of this tunnel syndrome.
Materials and methods. A pain intensity (on a visual analog scale), neurological status, walking ability, lower extremity function (on a Lower Extremity Functional Scale), and quality of life (using a NeuroQoL questionnaire), as well as the results of electroneuromiography, ultrasound examination of the nerves of the lower extremities, and magnetic resonance imaging of the hip joint were assessed before and after surgery in patient with Bernhardt-Roth syndrome.
Results. A patient with an atypical variant of Bernhardt-Roth syndrome underwent neurolysis of the lateral femoral cutaneous nerve. The positive effect of surgical treatment (improving the quality of life and restoring the functional status of the lower limb) was revealed.
Conclusion. Neurolysis of the lateral femoral cutaneous nerve is effective in the atypical version ofBernhardt—Roth syndrome.
About the Authors
A. A. Gusev
I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
6-8 L’va Tolstogo St., Saint Petersburg 197022
V. Yu. Cherebillo
I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia; S.M. Kirov Military Medical Academy, Ministry of Defense of Russia; V.A. Almazov National Medical Research Center, Ministry of Health of Russia
Russian Federation
Russian Federation
6-8 L’va Tolstogo St., Saint Petersburg 197022; 6 Lebedeva St., Saint Petersburg 194044; 12 Mayakovsky St., Saint Petersburg 191014
M. Yu. Kurnukhina
I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
6-8 L’va Tolstogo St., Saint Petersburg 197022
References
1. Filler A.G., Kline D.G., Toussaint C.P. et al. Management of peripheral nerve disorders. In: Youmans neurological surgery. 6 edn. Elsevier, 2011. Pp. 2361—2546.
2. Dreval O.N., Kuznetsov A.V., Dzhindzhikhadze R.S. et al. Clinical recommendations for the diagnosis and surgical treatment of injuries and diseases of the peripheral nervous system. Moscow, 2015. 34 p. (In Russ.). Available at: http://rnans.org/Text/Guidelines/peripheral_nerves.pdf.
3. Barinov A. Entrapment neuropathies: rationale for pathogenetic therapy. Vrach = The Doctor 2012;(4):31—7. (In Russ.).
4. Bernhardt M. Neuropathologische Beobachtungen. Deutsches Archiv far klinische Medicin 1878;22:362-93.
5. Roth W.K. Meralgia paraesthetica. Berlin: Karger, 1895.
6. Pearce J.M.S. Meralgia paraesthetica (Bernhardt-Roth syndrome). J Neurol Neurosurg Psychiatry 2006;77(1):84. DOI: 10.1136/jnnp.2005.072363.
7. Barinov A.N., Sergienko D.A. The Phenomenon of pelvic pain through the eyes of a neurologist. Nervnye bolezni = Nervous Diseases 2015;(2):20—7. (In Russ.).
8. Mumenthaler M., Stohr M., Mttller-Vahl H. Lesions of peripheral nerves and radicular syndromes. Transl. from German. 2nd edn. Moscow: Med-press-inform, 2014. 616 p. (In Russ.).
9. Хабиров Ф.А. Болевые синдромы в нижних конечностях. Практическая медицина 2017;1(1):13—21. [Khabirov F.A. Pain syndromes in the lower extremities. Prakticheskaya meditsina = Practical Medicine 2017;1(1):13—21. (In Russ.)].
10. Binkley J.M., Stratford P.W., Lott S.A., Riddle D.L. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties and clinical application. North American Orthopaedic Rehabilitation Research Network. Phys Ther 1999;79(4):371—83.
11. Vileikyte L., Peyrott M., Bundy C. et al. The development and validation of a neuropathy- and foot ulcer-specific quality of life instrument. Diabetes Care 2003;26(9): 2549—55. DOI: 10.2337/diacare.26.9.2549.
12. Komelyagina E.Yu., Uvarova O.M., Antsiferov M.B. Validation and perspectives of the Russian version of the quality of life questionnaire in patients with diabetic peripheral polyneuropathy. Sakharny diabet = Diabetes Mellitus 2014;(2):56—65. (In Russ.).
13. Bouhassira D., Attal N., Alchaar H. et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 2005;114(1—2):29—36. DOI: 10.1016/j.pain.2004.12.010.
14. Kaiser R. Meralgia paresthetica. Rozhl Chir 2018;97(6):286—90.
15. Agarwal N., Mistry J.B., Khandge P.V. et al. Meralgia paresthetica after spine surgery on the Jackson table. Clin Spine Surg 2018;31(2):53—7. DOI: 10.1097/BSD.0000000000000593.
Review
For citations:
Gusev A.A., Cherebillo V.Yu., Kurnukhina M.Yu. Surgical treatment of the atypical variant of Bernhardt—Roth syndrome (case report and review). Russian journal of neurosurgery. 2020;22(2):79-82. (In Russ.) https://doi.org/10.17650/1683-3295-2020-22-2-79-82
Views:
1658
Email this article 