Meralgia Paraestheticav

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  • Anatomy
• Meralgia paraesthetica refers to localised sensory symptoms of the outer thigh caused by compression of the lateral femoral cutaneous nerve
• Mononeuropathy


  It only affects a single nerve
• Basic Anatomy of lateral femoral cutaneous nerve

  Originates from varying combinations of L1, L2 and L3 nerve roots, comes from behind the psoas muscle, around the surface of the iliacus muscle and under the inguinal ligament onto the thigh, supplies sensory innervation to the upper-outer thigh
• Pressure, deformity or trauma to the lateral femoral cutaneous nerve can occur at several places
• The lateral femoral cutaneous nerve only carries sensory signals, so there are no motor symptoms with meralgia paraesthetica
• Presentation of meralgia paraesthetica

  Patients present with abnormal sensations (dysaesthesia) and loss of sensation (anaesthesia) in the lateral femoral cutaneous nerve distribution. Symptoms include burning, numbness, pins and needles, cold sensation, and may also include localised hair loss. Symptoms are aggravated by walking or standing for a long duration and improve when sitting down
• Symptoms of Meralgia Paraesthetica

  • Burning
  • Numbness
  • Pins and needles
  • Cold sensation
  • Localised hair loss
• Symptoms are aggravated by walking or standing for a long duration and improve when sitting down
• Symptoms are often worse with extension of the hip on the affected side
• Reproducing symptoms on examination

  Extension of the hip on the affected side
• Management of Meralgia Paraesthetica

  • Conservative
  • Medical
  • Surgical
• Conservative management

  • Rest
  • Looser clothing (tight clothes such as belts may add pressure to the nerve)
  • Weight loss (if appropriate)
  • Physiotherapy
• Medical management

  • Analgesia if pain is a feature, such as Paracetamol, NSAIDs, Neuropathic analgesia (e.g., amitriptyline, gabapentin, pregabalin or duloxetine), Local injections of steroids or local anaesthetics
• Surgical management

  • Decompression - removing pressure on the nerve, Transection - cutting the nerve, Resection - removing the nerve