Sympathetic blocks in the treatment of erythromelalgia: case series.
Semih Gungor, Burcu Candan
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Case in brief
This retrospective case series describes three patients with chronic, treatment-refractory erythromelalgia affecting the lower extremities despite prior neuropathic medications and conservative measures. Each underwent bilateral L3 lumbar sympathetic blocks. Two reported substantial pain and symptom improvement, with benefit lasting several months; the third had partial, short-term improvement. Blocks were repeated when symptoms recurred. The authors note that the small sample and retrospective design do not allow conclusions about treatment efficacy.
What made this case unusual
The series reports symptom improvement after lumbar sympathetic blocks in patients with refractory lower-extremity erythromelalgia, with benefit lasting several months in two patients.
Diagnostic / clinical pearl
In refractory lower-extremity erythromelalgia, lumbar sympathetic block was associated with symptom improvement in these cases, but the findings do not establish efficacy.
Why it matters
The cases highlight the need for further study to clarify patient selection and long-term outcomes for this intervention.