A case of idiopathic multiple mononeuropathy in which ultrasound-guided sciatic nerve block contributed to symptomatic improvement

Abstract

We report the case of a 56-year-old female suffering from right lower limb pain. She was diagnosed with idiopathic multiple mononeuropathy by the Department of Neurology and referred to us for pain control. The patient showed claudication in her gait due to pain. Her pain measured 29 mm on the visual analogue scale (VAS). Lumbar epidural blocks (three times/month) were ineffective. However, ultrasound-guided popliteal sciatic nerve blocks (four times/month) contributed to improvement. Multiple mononeuropathy is a disease in which inflammation occurs in peripheral nerves due to conditions such as metabolic diseases, drugs, and collagen diseases. The epidural block was ineffective, but the sciatic nerve block was effective in this case. The direct penetration of local anesthesia at the region of neuritis shows an anti-inflammatory effect, and improved the symptoms. This suggests that a peripheral nerve block may improve symptoms relating to diseases in which a nerve block near the central axis has not been effective.