Meralgia Paresthetica: Diagnosis and Management Strategies

Abstract

Meralgia paresthetica (MP), coined from the Greek words meros (thigh and algos), meaning pain, is a neurological disorder characterized by a localized area of paresthesia and numbness on the anterolateral aspect of the thigh. The incidence of MP is more common than often reported in the literature. The etiology of MP includes mechanical factors such as obesity, pregnancy, and other conditions associated with increased intrabdominal pressure, surgery of the spine, and pelvic osteotomy. A coherent history and pertinent physical examination is essential in making the diagnosis; however, red flags such as tumor and lumbar disk herniations must be recognized and appropriately treated. While the diagnosis of MP is essentially a clinical diagnosis, sensory nerve conduction velocity studies are a useful adjunctive diagnostic tool. The management of MP includes treating the underlying cause (if any) and conservative management. Surgery should only be adopted when all nonoperative therapies have failed to manage the condition in an effective manner.

Simvastatin-Induced Meralgia Paresthetica

“…Patients usually describe a burning, stinging, or tingling sensation in the thigh and can usually localize the sensation to the skin itself. 1 The patients do not have back pain, weakness, or reflex changes. 10 The symptoms are usually unilateral, though 20% of patients complain about bilateral symptoms that tend to be aggravated by erect posture (as reported by this patient) and prolonged standing.…”

“…10 The symptoms are usually unilateral, though 20% of patients complain about bilateral symptoms that tend to be aggravated by erect posture (as reported by this patient) and prolonged standing. 1 The lateral femoral cutaneous nerve supplies sensation to a large oval area of skin over the lateral and anterior thigh. 10 The differential diagnosis includes femoral neuropathy, lumbar plexopathy, and high lumbar radiculopathy.…”

Concurrent meralgia paresthetica and radiculopathy of the left leg -A case report-

“…If the symptoms are relieved, the result of the test is regarded as positive [6,9]. In addition, the screening test is useful in gauging tenderness on the lateral inguinal ligament where the nerve bypass is detectable during physical examination [1]. MP is purely sensory and does not follow dermatomal distributions, in contrast to intervertebral disc herniation, in which there may be reflex or motor deficits.…”

“…After detailed history taking and lateral femoral cutaneouse nerve block, he was diagnosed with MP. Meralgia paresthetica (MP) is a sensory mononeuropathy of the lateral femoral cutaneouse nerve (LFCN), which is commonly due to focal entrapment of this nerve as it passes through the inguinal ligament [1][2][3]. However, corresponding presentations in the same area of both MP and L4, L5…”

Variation in Formation of Lateral Femoral Cutaneous Nerve – A Case Study

“…It functions primarily as a sensory nerve and its composition varies among individuals with several different combinations of lumbar nerves that originate from L1 to L3 (2) . The lateral femoral cutaneous nerve has received much attention because of its association with meralgia paresthetica (3) . …”