Ultrasound-guided Perineural Vitamin B12 Injection for Peripheral Neuropathy

Abstract

The objective of this article is to present an innovative treatment for peripheral neuropathy using ultrasound-guided perineural vitamin B 12 injection. A 37-year-old patient presented with a progressive dropped foot for 2 months. Preceding trauma was denied. On examination, severe weakness of ankle dorsiflexion was revealed. Ultrasound showed peroneal nerve swelling. Nerve conduction velocity and electromyography study showed results compatible with peroneal neuropathy. Under the diagnosis of peroneal neuropathy, the patient was given 500 μg of methylcobalamin around the peroneal nerve under ultrasound guidance two times, with an interval of 2 weeks. The patient showed improvement of muscle power within 2 weeks. Full muscle power was regained after 3 months. There was no adverse symptom after ultrasound-guided perineural vitamin B 12 injection. Ultrasound-guided perineural vitamin B 12 has the advantage of precise delivery of high-dose vitamin B 12 directly around the defective nerve.