Delayed Diagnosis of Meralgia Paresthetica: A Case Report

Abstract

Meralgia paresthetica (MP, or Bernhardt-Roth syndrome) is a painful mononeuropathy resulting from the compression of the lateral femoral cutaneous nerve (LFCN) as it crosses between the anterior superior iliac spine and the inguinal ligament to enter the thigh. Although the diagnosis of MP is straightforward based on its typical presentation, other neuropathies such as lumbar disc herniation or stenosis may mimic MP and complicate the diagnosis. We report a case of delayed diagnosis of MP due to concomitant lumbar disc herniation. A 49-year-old female patient presented with a 2-year history of gradually worsening pain and paresthesias in her left anterior thigh and left buttock. Magnetic resonance imaging of the lumbar spine revealed disc herniation at the level of L4/5. The diagnosis of MP was made after relief from buttock pain using repeated epidural blocks. Although MP was diagnosed late, decompression of the LFCN resulted in immediate and permanent relief of chronic anterior thigh pain. Unexplained, chronic anterolateral thigh pain and paresthesias warrant careful investigation for the possibility of MP.

Updates to the Physiologic Mechanism, Anatomical Sites, and Diagnostic Utility of the Scratch Collapse Test: A Systematic Review

“…Key for Figure 1B: 8. trigger sites for migraine surgery 21 ; 9. cervical radiculopathy 22 ; 10. thoracic outlet syndrome 23 ; 11. anterior cutaneous nerve entrapment syndrome 24 ; 12. Meralgia paresthetica/lateral femoral cutaneous nerve 25 ; 13. common peroneal nerve compression 6 ; 14. tarsal tunnel syndrome 26 Faszholz and Cheng • Systematic Review of the SCT ranging from seconds to tens of minutes in tissues and blood and extends up to hours in plasma. 41 Given that SP's presence in tissues and plasma exceeds the momentary duration of the SCT, it seems less plausible as a mechanism of triggering transient loss of voluntary muscle activation and establishes the CSP as the stronger hypothesis.…”

“…Anterior cutaneous nerve entrapment syndrome 24 ; 12. Meralgia paresthetica/lateral femoral cutaneous nerve 25 ; 13. Common peroneal nerve compression 6 ; 14.…”

“…Key for Figure1B:8. trigger sites for migraine surgery 21 ; 9. cervical radiculopathy 22 ; 10. thoracic outlet syndrome23 ; 11. anterior cutaneous nerve entrapment syndrome24 ; 12. Meralgia paresthetica/lateral femoral cutaneous nerve25 ; 13. common peroneal nerve compression 6 ; 14. tarsal tunnel syndrome26 ; 15. Piriformis syndrome 27 ; 16. long thoracic nerve palsy 28.…”