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Revista de la Sociedad Española del Dolor
Print version ISSN 1134-8046
Abstract
OTERO VILLAVERDE, S et al. Peroneal neuropathy caused by an extraneural ganglion: literary review and treatment proposal. A non-positive case. Rev. Soc. Esp. Dolor [online]. 2021, vol.28, n.6, pp.354-357. Epub Apr 25, 2022. ISSN 1134-8046. https://dx.doi.org/10.20986/resed.2022.3919/2021.
Lumbar disc disease with L4 or L5 lumbar root involvement is a common cause of medical attendance. In severe circumstances it can lead to neuropathic pain, weakness and foot drop. However, this clinical presentation is not always related with lumbar or central nervous system pathology, being the differential diagnosis of great importance.
It is reported a case of 69-year-old patient with a peroneal nerve entrapment caused by an extraneural ganglion, misdiagnosed as a L5 radiculopathy.
This incorrect approach entailed patient overmedication, poor pain control, an unnecessary L4-L5 discectomy, and a poor neurological outcome. In this case, an early diagnosis and therapeutic approach would have meant not only a greater clinical improvement and even a complete neurological recovery. Moreover, this case highlights: a) the value of ecography in peripheral neuropathies as a diagnostic and prognostic tool and ultrasounds in ganglions cyst as a diagnostic and therapeutic weapon; b) the use of diagnostic tests to support a thorough physical examination, not as a diagnosis themselves; and c) the importance of non-positive cases publication to optimize resources, avoid repeating mistakes, reduce publication bias and facilitate the start of research projects.
Keywords : Pain unit patient profile; pain unit management; pain unit assistance planning; psychiatric disorders and pain.