-The article pertains to the uncommon clinical case of a patient with a proximal neuropathy of the lower extremity. It outlines the electrophysiological evaluation and reviews the medical literature. The electrophysiologic test that most accurately revealed the neuropathy was the segmental somatosensory evoked potential (SEP) of the lateral cutaneous branch of the iliohypogastric nerve. It showed well-defined and replicable cortical waveforms following the excitation of the lateral cutaneous branch of the iliohypogastric nerve in the asymptomatic lower extremity, but failed to present somatosensory evoked potentials arising from the excitation of the contralateral nerve in the symptomatic lower extremity. We did not find any previous reports diagnosing that particular pathology by the use of segmental SEP. In conclusion, it is important to remember that the accurate diagnosis of patients complaining of pain and dysesthesia in the proximal part of the lower extremities can possibly be achieved through the use of electrophysiologic tests such as the segmental SEP.KEY WORDS: neuropathy, nerve injury, nerve entrapment, iliohypogastric nerve, somatosensory evoked potential. Neuropatia do ramo cutâneo lateral do nervo ílio-hipogástrico diagnosticada por PES: relato de casoRESUMO -O presente artigo relata caso clínico incomum de neuropatia proximal de membro inferior, demonstra eletrofisiologicamente o comprometimento neural e revisa a literatura médica sobre o assunto. O teste neurofisiológico que demonstrou a patologia foi o potencial evocado somato-sensitivo (PES) segmentar do ramo cutâneo lateral do nervo ílio-hipogástrico. Ele revelou potenciais corticais bem definidos e replicáveis à estimulação do membro inferior assintomático, mas falhou em produzir respostas corticais do membro inferior sintomático. Na revisão da literatura não foi encontrado nenhum relato anterior de diagnós-tico dessa patologia por PES segmentar. Conclui-se que é importante ter em mente ao avaliar pacientes com queixas de dor e disestesia na base dos membros inferiores que o acometimento de pequenos ramos cutâneos, como o cutâneo lateral do ílio-hipogástrico, pode ter confirmação eletrofisiológica da patologia por testes neurofisiológicos como o potencial evocado somato-sensitivo segmentar.PALAVRAS-CHAVE: neuropatia, nervo ílio-hipogástrico, potencial evocado somato-sensitivo.Proximal neuropathies of the lower extremities, with the exception of the lateral femoral cutaneous neuropathy, are uncommon causes of pain and paresthesia 1 . As such, these pathologies can often present a diagnostic challenge for the physician. There are several proximal neural branches of the lower extremities that can suffer nerve entrapment: the cluneal, the lateral cutaneous branch of the iliohypogastric and the subcostal 2,3 . This paper references one specific neuropathy that affects the lateral cutaneous branch of the iliohypogastric nerve, as revealed by the segmental somatosensory evoked potential (SEP).Review of anatomy -The iliohypogastric nerve is...
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