Percutaneous Electrical Nerve Stimulation (PENS) for Infrapatellar Saphenous Neuralgia Management in a Patient with Myasthenia gravis (MG)

  1. Martín Pérez, Sebastián Eustaquio 1233
  2. Martín Pérez, Isidro Miguel 33
  3. Sánchez-Romero, Eleuterio A. 1224
  4. Sosa Reina, María Dolores 22
  5. Muñoz Fernández, Alberto Carlos 22
  6. Alonso Pérez, José Luis 1225
  7. Villafañe, Jorge Hugo 6
  1. 1 Universidad Europea de Canarias

    Universidad Europea de Canarias

    Orotava, España


  2. 2 Universidad Europea de Madrid

    Universidad Europea de Madrid

    Madrid, España


  3. 3 Universidad de La Laguna

    Universidad de La Laguna

    San Cristobal de La Laguna, España


  4. 4 Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO)
  5. 5 Onelife Center, Multidisciplinary Pain Treatment Center, 28925 Alcorcón, Spain
  6. 6 IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
International Journal of Environmental Research and Public Health

ISSN: 1660-4601

Year of publication: 2023

Volume: 20

Issue: 3

Pages: 2617

Type: Short Survey

DOI: 10.3390/IJERPH20032617 GOOGLE SCHOLAR lock_openOpen access editor

More publications in: International Journal of Environmental Research and Public Health


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Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness of the cranial and skeletal muscles, however, neuropathies are extremely rare. In this case report we present a case of a 61-year-old man diagnosed Myasthenia gravis who came to our attention due to a 1 week of acute deep pain [NPRS 8/10] in the anterior and medial right knee which occurred during walking [NPRS 8/10] or stair climbing [NPRS 9/10]. A complete medical record and clinical examination based on physical exploration and ultrasound assessment confirmed a infrapatellar saphenous neuralgia. Therapeutic interventions included Percutaneous nerve electrical stimulation combined with pain neuroscience education, neural mobilization of the saphenous nerve and quadriceps resistance exercises. After 4 weeks, pain intensity [NRPS = 1/10], knee functionality [OKS = 41/48] and lower limb functionality [LLFI = 80%] were notably improved, nevertheless, fatigue [RPE = 2/10] was similar than baseline. At 2 months of follow-up, the effect on intensity of pain NRPS [0/10] and functionality OKS [40/48] and LLFI [82%] was maintained, however, no significant clinical changes were detected on perceived fatigue RPE Scale [2/10]. Despite the important methodological limitations of this study, our case report highlights the efficacy of percutaneous electrical nerve stimulation combined with physical agents modalities for pain and functionality of infrapatellar saphenous neuralgia in the context of Myasthenia gravis.

Funding information

The publication of this work has been financed by the European University of Canary Islands, C/Inocencio García 1 38300 La Orotava, Tenerife, 38300 Canary Islands, Spain


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