Misdiagnosed chronic pelvic pain: Pudendal neuralgia responding to a novel use of palmitoylethanolamide

Background.: Pudendal neuralgia is a cause of chronic, disabling, and often intractable perineal pain presenting as burning, tearing, sharp shooting, foreign body sensation, and it is often associated with multiple, perplexing functional symptoms. Case Report.: We report a case of a 40-year-old man presenting with chronic pelvic pain due to pudendal nerve entrapment and successfully treated with palmitoylethanolamide (PEA). Conclusion.: PEA may induce relief of neuropathic pain through an action upon receptors located on the nociceptive pathway as well as a more direct action on mast cells via an ALIA (autocoid local injury antagonism) mechanism.As recently demonstrated in animal models, the present case suggests that PEA could be a valuable pharmacological alternative to the most common drugs (anti-epileptics and antidepressants) used in the treatment of neuropathic pain. Wiley Periodicals, Inc.