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Meralgia Paresthetic

Meralgia paresthetica is a neurological condition characterized by abnormal sensations such as tingling, numbness, or pain in the outer thigh. It results from compression or irritation of the lateral femoral cutaneous nerve, which supplies sensation to the skin of the anterolateral thigh. Risk factors include obesity, diabetes, pregnancy, and tight clothing. Diagnosis involves medical history, physical examination, and sometimes nerve conduction studies. Treatment options range from conservative measures like weight loss and physical therapy to corticosteroid injections or rarely, surgical decompression.

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42 views14 pages

Meralgia Paresthetic

Meralgia paresthetica is a neurological condition characterized by abnormal sensations such as tingling, numbness, or pain in the outer thigh. It results from compression or irritation of the lateral femoral cutaneous nerve, which supplies sensation to the skin of the anterolateral thigh. Risk factors include obesity, diabetes, pregnancy, and tight clothing. Diagnosis involves medical history, physical examination, and sometimes nerve conduction studies. Treatment options range from conservative measures like weight loss and physical therapy to corticosteroid injections or rarely, surgical decompression.

Uploaded by

victorkabale
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Meralgia Paresthetica

Chimwemwe Mvula [42102 ]


Victor Kabale [38167 ]
Introduction
Meralgia paresthetica is a neurological condition
characterized by abnormal sensations, such as
tingling, numbness, or pain, in the outer thigh.It
results from compression or irritation of the lateral
femoral cutaneous nerve (LFCN), which supplies
sensation to the skin at the Anterolateral thigh

As known as Bernhardt-Roth syndrome


Anatomy
Site of entrapment:

at the perforation of the inguinal


ligament medial to the anterior
superior iliac spine.

Origin : Lumbar Plexus (L2-L3)

Innervation: Sensation to the skin


on the lateral and anterior aspects
of the thigh
Epidemiology
This condition is more common in men than women and often occurs in individuals aged
30-40. The prevalence is higher in individuals with risk factors like obesity, diabetes,
pregnancy, and those who wear tight clothing.

The incidence of Meralgia Paresthetica is estimated to be 32.6 per 100,000 person-years


Etiology
Mechanical
● Pregnancy
● Increased abdominal pressure
● Obesity
● Wearing tight clothing
● Different Leg lengths
● Carrying items such as a wallet in the front pocket of pants
Metabolic
● Diabetes
● Alcoholism
● Hypothyroidism
● Lead poisoning

Iatrogenic
● Prolonged traction during spine surgery or
● Injury to the nerve during retroperitoneal dissection
Risk factors
Obesity: Excess weight can increase pressure on the nerve.

Diabetes: Neuropathy associated with diabetes may contribute to nerve compression.

Pregnancy: Increased abdominal pressure during pregnancy can compress the nerve.

Tight Clothing: Wearing tight belts, waistbands, or other constrictive clothing can
exacerbate compression.
Differential diagnosis
● Spinal nerve radiculopathy at L1-L3
● Malignancy or metastasis to the iliac crest
● Uterine fibroids or pelvic mass that compress the nerve
● Avulsion fracture of the Anterior Superior Iliac Spine (ASIS)
● Chronic Appendicitis
Complications
Complications:

While meralgia paresthetica is generally not serious, chronic symptoms may lead to
complications such as
● decreased quality of life,
● interference with daily activities,
● psychological distress
● Chronic pain
● Sleep disturbances
Signs and symptoms
Symptoms: Signs:
● Pain ● Reduced sensitivity to light
● Numbness touch
● Tingling ● Abnormal responses to sensory
stimuli
● Other neurological indicators
specific to the affected area
Investigation/diagnosis
Diagnosing meralgia paresthetica involves a thorough clinical assessment:

Medical History: Understanding the patient's symptoms, risk factors, and relevant medical
history.

Physical Examination: Identifying sensory abnormalities, ruling out other conditions, and
locating areas of tenderness.

Nerve Conduction Studies (NCS) and Electromyography (EMG): These tests can help
confirm nerve compression and rule out other neurological conditions.
Pelvic Compression test
● The pelvic compression test is diagnostic
tool that involves placing the patient in the
lateral recumbent position while an external
downward force is applied with the
examiner’s hands over the lateral aspect of
the ASIS
● The pressure is held for 45 seconds to
determine if the patient’s symptoms
improved.
● Symptom amelioration is considered a
positive test result and helps rule out
lumbosacral radicular pain
Management and Treatment
Conservative Measures: Addressing underlying causes,
such as weight loss and avoiding tight clothing.
Physical Therapy: Stretching and strengthening
exercises to improve symptoms and prevent recurrence.
Medications: Analgesics, anti-inflammatory drugs, or
anticonvulsants for pain relief.
Corticosteroid Injections: In severe cases, injections may
reduce inflammation.
Surgical Decompression: Rarely, surgical intervention to
relieve nerve compression.
References
https://dynamicnaples.com/blog/2019/8/7/nerve-entrapment-in-the-hip
Lee SH, Shin KJ, Gil YC, Ha TJ, Koh KS, Song WC. Anatomy of the lateral femoral cutaneous nerve relevant to clinical
findings in meralgia paresthetica. Muscle Nerve. 2017;55:646–50.

Ivins GK. Meralgia paresthetica, the elusive diagnosis: clinical experience with 14 adult patients. Ann Surg.
2000;232(2):281‐286

van Slobbe AM, Bohnen AM, Bernsen RM, et al. Incidence rates and determinants in meralgia paresthetica in general
practice. J Neurol. 2004;251(3):294‐297

Parisi TJ, Mandrekar J, Dyck PJ, et al. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus.
Neurology. 2011;77(16):1538‐1542

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