Meralgia Paresthetica Review: Update on Presentation, Pathophysiology, and Treatment

Abstract

Purpose of Review Meralgia paresthetica (MP) is a condition characterized by paresthesias, neuropathic pain, and alterations in sensorium of the anterolateral thigh secondary to impingement of the lateral femoral cutaneous nerve (LFCN). MP is generally diagnosed by clinical history and is often a diagnosis of exclusion. When diagnosis remains a challenge, diagnostic modalities such as ultrasound, MRI, electromyography, and nerve conduction studies have been utilized as an adjunct. This review summarizes the most recent medical literature regarding MP, its pathophysiology, presentation, and current treatment options. Recent Findings Treatment options for patients with MP range from lifestyle modifications and conservative management to surgical procedures. Initial management is often conservative with symptoms managed with medications. When conservative management fails, the next step is regional blocks followed by surgical management. The conflicting data for treatment options for MP highlight how the evidence available does not point to a single approach that’s universally effective for treating all patients with MP. Summary Despite the apparent success at treating MP with regional blocks and surgical interventions, much remains to be known about the dosing, frequency, and optimal interventions due to the inconclusive results of current studies. Further research including randomized controlled trials are needed to better understand the most optimal treatment options for MP including studies with a larger number of participants.

Exoscope for revision of right lateral femoral cutaneous nerve decompression

“…And based on both the consistency of her symptoms with regard to mapping out the territory of the lateral femoral cutaneous nerve in her clinical diagram, as well as her response to localized injection under ultrasound guidance, we recommended consideration of repeat decompression of the lateral femoral cutaneous nerve. [2][3][4][5][6] 1:44 Rationale for Exoscope. At the time, we decided to proceed with an exoscope approach for revision decompression.…”

Surgical Approaches in Total Hip Arthroplasty

“…The rate of injury of the LFCN associated with the DAA is variable between studies with reports ranging from 0.1% to 81% [ 16 , 17 ]. Fortunately, injury to the LFCN does not lead to major neurological deficits and patients report sensations of numbness or burning in the anterolateral region of the high at worst [ 18 ].…”