Meralgia Paresthetica

Abstract

The symptoms of meralgia paresthetica are pain, numbness, itching, or other dysesthesias occurring in the distribution of the lateral femoral cutaneous nerve of the thigh, that is, over the anterolateral aspect of the thigh, usually in an elliptical patch and usually unilateral. In this area percep¬ tion of pinprick and touch often is di¬ minished or lost. There is no motor disturbance ; the lateral femoral cutaneous nerve is entirely sensory.Many writers are patently incorrect in describing this condition as rare. Other inconsistencies and contradictions in the literature are regularly found, particularly in regard to age of onset, predilection for one sex, course, prognosis, and treatment. The literature on the etiology of meralgia paresthetica is particularly obfuscating. The multiplicity of ascribed causes, often asserted with strong conviction, further signalizes the need for accumulation and clarification of data on this common afflic¬ tion. This syndrome often is diagnosed in¬ correctly and misconstrued by the patient or practitioner as representing a sinister disease process. It is noteworthy that pa¬ tients with this disorder may consult or be treated by physicians in a wide range of

Lateral femoral cutaneous neuralgia: An anatomical insight

“…The value was found to be 100 Ϯ 10°with no significant difference as to side or gender. Most authors emphasize that lateral femoral cutaneous neuralgia is found predominantly in men (Stevens, 1957;Moscona and Sekel, 1978;Streiffer, 1986). According to our study, the greater incidence of this syndrome in men than in women cannot be accounted for by the presence of a more acute angle in males.…”

“…The strategy is simple: the nerve is approached either in the thigh (infrainguinal ligament approach) or in the pelvis (suprainguinal ligament approach) and followed to the IL, at which time a decision to section or decompress is made (Williams and Trzil, 1991;van Eerten et al, 1995). Surprisingly, the results of surgical treatment of meralgia paresthetica are not as favorable as surgical treatments for other neuropathies caused by compression, such as carpal tunnel syndrome (Stevens, 1957;Kitchen and Simpson, 1972;Aldrich and van den Heever, 1989;Williams and Trzil, 1991), which influence the therapeutic strategy. For example, when faced with the failure of medical treatment, in most cases, surgery is still not indicated and the patient has to live with the symptoms; however, this situation is not always accepted with tacit resignation and some patients insist on having surgical treatment (Williams and Trzil, 1991), proving that meralgia paresthetica is not always a bearable condition.…”

Postoperative lateral femoral cutaneous neuropathy

“…1 The patient may describe a widely distributed ache involving the thigh, aggravated by standing and walking, and relieved by sitting down. 5 Lateral femoral cutaneous neuropathy is most often associated with obesity, pregnancy, and compression by a tight belt, corset, or jeans. 6 During surgery, the LFC nerve may be traumatized directly by a surgical instrument, may be compressed by the weight of the surgeon's arm while manipulating instruments, and may be stretched by prolonged extension of the hip or compressed by prolonged hip flexion.…”

“…6 During surgery, the LFC nerve may be traumatized directly by a surgical instrument, may be compressed by the weight of the surgeon's arm while manipulating instruments, and may be stretched by prolonged extension of the hip or compressed by prolonged hip flexion. 1,[5][6][7] Postoperatively, the LFC nerve may be injured by injection of medication into the anterolateral thigh. 1 When a nerve is injured by stretch, compression, or direct trauma, the injury is immediate.…”

“…1,5,6 This case report provides an example of an alternative explanation: compression of the LFC nerve under the inguinal ligament due to prolonged hip flexion to reduce the incisional pain during the postoperative period.…”