Neuro

Meralgia Paresthetica

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Meralgia Paresthetica, Lateral Femoral Cutaneous Nerve Entrapment

  • Pathophysiology
  1. Compression Neuropathy
  2. Entrapment of lateral femoral cutaneous nerve
  3. Associated with compression at inguinal ligament
  • Associated conditions
  1. Obesity
  2. Wide belt
  3. Corset or tight jeans
  4. Pregnancy
  5. Diabetes Mellitus
  6. Prior inguinal surgery
  • Symptoms
  1. Paresthesias or Dysesthesias at proximal lateral thigh
    1. Known as Meralgia Paresthetica
    2. Burning sensation
    3. Tingling or stinging pain
    4. Numb sensation
  2. Pain radiation
    1. Knee
    2. Buttock
    3. Low back
  3. Unilateral in most cases (may occur bilaterally)
  4. Provocative factors
    1. Sitting with involved leg under body
      1. Women commonly sit in this position
      2. Rifle team members
    2. Prolonged sitting or squatting
    3. Increased walking or standing
  • Signs
  1. Motor function fully intact
  2. Hyperesthesia over lateral thick
    1. Increased light Touch Sensation
    2. Increased pinprick sensation
  • Differential Diagnosis
  1. Femoral Neuropathy
  2. Lumbar Radiculopathy (L2-3, L3-4)
  3. Lumbar plexus lesions
  • Diagnosis
  • Management
  1. Clothing changes
    1. Avoid wide belts
    2. Avoid tight garters or girdles
  2. Weight loss
  3. Capsaicin
  4. Elavil 30 mg qhs
  5. Local Anesthetic and Corticosteroid
  6. Surgery rarely indicated
    1. Surgical Decompression
    2. Destruction of lateral femoral cutaneous nerve
  • Course
  1. Spontaneous resolution in many cases by 2 years