Meralgia Paresthetica in the Pediatric Population: A Propos of 2 Cases

Abstract

Meralgia paresthetica is a mononeuropathy affecting the lateral femoral cutaneous nerve that is extremely rare in children. Two adolescent females, aged 11 and 13 years, presented due to tingling and pain on the side of the thigh of 2 to 3 weeks duration. The general examination revealed mild obesity; the neurological examination of both patients is normal except for pain, hypo- or hyperesthesia on the side of the quadriceps. An electromyogram was performed in the first case that reveals decreased conduction velocity of the affected lateral femoral cutaneous nerve. The younger child was treated successfully with diet and topiramate; the second patient's symptoms disappeared after initiating conservative measures. Meralgia paresthetica is probably underdiagnosed in the pediatric population. First-line treatment should be conservative, but topiramate may be useful for the treatment of meralgia paresthetica, although broader studies are needed to evaluate its true effectiveness in this pathological condition.

Meralgia paresthetica after incorrect crutch usage in a boy with a wide abdomen

“…Contributing factors include obesity, diabetes mellitus, tight garments around the waist, a wide abdomen with overlying panniculi and extension of the thigh posteriorly, which stretches the nerve . Of the six previously reported pediatric cases in patients 9–16 years old, three involved obesity, but waist circumference was not reported . The present patient had normal BMI but a slightly abnormal obesity index and a wide abdomen for his height.…”

“…Meralgia paresthetica is extremely rare in children, with knowledge largely limited to a few case reports . The nerve entrapments that produce meralgia paresthetica usually occur under the inguinal ligament.…”

Interventional Procedures for Chronic Pain in Children and Adolescents: A Review of the Current Evidence

“…Lateral femoral cutaneous nerve block: Meralgia paresthetica is a syndrome that has been well‐described in both adults and children and is best treated with a multidisciplinary approach . The lateral femoral cutaneous nerve block can be effectively employed as adjunctive therapy for this chronic condition .…”

20. Meralgia Paresthetica

“…Even though MP can develop spontaneously at any age, the disease usually presents in the 30‐ to 40‐year age group 3 . The incidence in children could be higher than originally assumed 4 . MP appears in one‐third of children who have undergone surgery for an osteoid osteoma 3 .…”

“…3 The incidence in children could be higher than originally assumed. 4 MP appears in one-third of children who have undergone surgery for an osteoid osteoma. 3 An incidence of 0.43 in 10,000 was found in a Dutch study of a population of first-line care of 173,375 patients.…”