A case in which a lumbar sympathetic ganglion block using radiofrequency thermocoagulation and absolute ethanol was effective for treatment-induced diabetic neuropathy with distal symmetric polyneuropathy

Abstract

A most common type of diabetic neuropathy is distal symmetric polyneuropathy, of which 15–20％ is painful. Other painful types exist, including treatment induced neuropathy of diabetes. Pregabalin and duloxetine are generally used for drug treatment of painful diabetic neuropathy, but nerve block therapy is considered when sufficient efficacy is not obtained. Although there is no nerve block therapy with established evidence, the lumbar sympathetic ganglion block is a treatment option when peripheral blood flow disorders are suspected to be involved in the pathology. We report a case of bilateral lower extremity pain associated with distal symmetric polyneuropathy and treatment-induced diabetic neuropathy, in which a lumbar sympathetic ganglion block using radiofrequency thermocoagulation and absolute ethanol was effective.