Differential Etiological Diagnosis of Meralgia Paresthetica: A Concise Review

Abstract

Paresthesia meralgia (MP) is a condition in which there is compression of the lateral femoral cutaneous nerve (LFCN), with its entrapment. Clinically presents with burning pain and dysesthesia in the anterolateral region of the thigh. Due to the multiple etiological diagnoses different from MP, this review aims to show systemic and non-systemic causes and also explains some tests of the condition. This article is a non-systematic review. All articles used were researched in the public databases PubMed, Medline, ScienceDirect, SciELO and Cochrane. The process of locating these articles was done by searching for terms related to paresthesia meralgia, selecting the most relevant articles available in English or Portuguese. The presentation of MP is usually unilateral, with subacute onset (days to weeks), and may be associated with prolonged hip extension, in addition to flexion relief. There is a wide spectrum of non-systemic diseases that may be responsible for the development of paresthetic meralgia, ranging from surgical sequelae and direct mechanical nerve compression. In addition, diabetes mellitus and Covid-19 infection may be systemic causes of MP. Diabetes mellitus is associated with endothelial dysfunction and peripheral neuropathy. Covid-19 increases the inflammatory state and consequent pain of the intensive care unit patient causing neurological sequelae. In sum, the etiological diagnosis of MP is important, since the treatment varies according to the cause of this neuropathy. In addition, it helps to rationalize the process of diagnosis, investigation, treatment and follow-up of these patients.