Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2019
Bilateral distribution of anterior cutaneous nerve entrapment syndrome (ACNES): are clinical features and outcomes comparable to unilateral ACNES?
Mirror-image pain may occur in the presence of a one-sided peripheral nerve lesion leading to a similar distribution of pain on the contralateral side of the body ("mirrored"). Anterior cutaneous nerve entrapment syndrome (ACNES) is a neuropathic pain syndrome due to entrapment of terminal branches of intercostal nerves T7-12 in the abdominal wall and sometimes presents bilaterally. This study aims to address specifics of bilateral ACNES and to determine potential differences in clinical presentation and treatment outcomes when compared with the unilateral form of ACNES. ⋯ One in eight patients with ACNES has bilateral abdominal wall pain. Characteristics are similar to unilateral ACNES cases. Further studies aimed at underlying mechanisms in mirror image pain pathogenesis could provide a more targeted approach in the management of this neuropathic pain.