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.