Neurological Disorders: Meralgia Paresthetica

Introduction

Meralgia Paresthetica is a disease of the nervous system characterized by pain & paresthesia symptoms on the lateral aspect of the thigh generally due to an entrapment neuropathy.

Paresthesia is the term used for tingling (pins & needles) and/or numbness sensation. Entrapment neuropathy is the term for nerve damage due to pinching or compression. In these patients the paresthesia symptoms are produced usually by entrapment induced injury to the nerve.

More info on this nerve

The nerve which gets compressed in this case is lateral femoral cutaneous nerve. It is a branch from the upper lumbar plexus. It travels below the inguinal ligament in the groin area and reaches the lateral aspect of the thigh and carries the sensation from this area of thigh to the spinal cord.

Causes of this condition

Compression of this nerve under the inguinal ligament due to any cause can trigger this condition. Wearing tight undergarments, pregnancy, obesity especially recent rapid weight gain are some of the common. Diabetic patients are more vulnerable to develop many entrapment neuropathies like this condition, carpal tunnel syndrome etc. Injuries due to traumas or certain surgeries in the groin area can damage this nerve and produce this condition.

How does the patient present?

Tingling and/or numbness on the lateral aspect of the thigh is the commonest symptom in these patients. Sometimes they complain of burning sensation over the affected skin. The area becomes sensitive to touch and the cloth material can cause lot of irritation. Motor weakness, bowel & bladder symptoms are not associated with this condition and if such symptoms are present then additional or other causes should be suspected.

Diagnosis

It still remains mainly a clinical diagnosis because the investigations may not always help much in clinching the diagnosis. EMG/NCS (electromyography and nerve conduction study) is done in some neurology laboratories but because of high current needed to stimulate the nerve that too around the groin area makes this test uncomfortable. In some labs evoked potential study of this nerve is performed. Side to side comparison (comparing the results with the normal side) makes the test more reliable.

Treatment

The following treatment modalities are tried for patients with Meralgia Paresthetica;

• Wearing loose undergarments
• Wight loss
• Diabetes control
• Symptomatic management with medications like gabapentin
• Lateral femoral cutaneous nerve block
• Surgical decompression of this nerve etc.

Neurologist, pain specialist, and surgeon are some of the medical specialists involved in the care of these patients.

Meralgia Paresthetica to Neurology Articles

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