ABSTRACT
ABSTRACT Objective The objective of our study was to report 5 years of experience in the recognition and management of refractory meralgia paresthetica (MP) in patients who had undergone posterior approach lumbar surgery. Methods Patients who were submitted to procedures in the lumbar spine from January 2010 to January 2015 in three different hospital centers in Belo Horizonte/MG were selected for an evaluation of the postoperative development of MP. A prospective observational comparative case series study. Level of evidence III. Evaluation of the following parameters: type of support for the patient, surgical time, body mass index. Results 367 posterior approach lumbar spine surgeries for degenerative pathologies of the lumbar spine were performed. MP was observed in 81 patients (22%). In 65 of those patients (80%), there was complete resolution of the symptoms with conservative management (local measures and medications for neuropathic pain) in less than two months. Twelve patients improved with a corticosteroid depot injection in the inguinal ligament and four patients required a surgical procedure in the third month. Pneumatic support was the least involved in the development of MP, as well as surgical time <1h and body mass index <25. Conclusion Refractory MP may occur in patients submitted to posterior approach lumbar spine surgeries. Management includes local measures, medications for neuropathic pain, and corticosteroid injection in the inguinal ligament. Decompression surgery is reserved for rare refractory cases. Level of evidence III; Prospective observational study with comparative case series.
RESUMO Objetivo O objetivo do presente estudo consiste em relatar a experiência de cinco anos no reconhecimento e manejo da meralgia parestésica (MP) refratária em pacientes submetidos a cirurgias lombares por via posterior. Métodos Pacientes submetidos a procedimentos na coluna lombar, no período de janeiro de 2010 a janeiro de 2015, em três diferentes centros hospitalares de Belo Horizonte/MG, foram selecionados para avaliação do desenvolvimento da MP pós-operatória. Estudo prospectivo observacional com série de casos comparativos. Nível III de evidência. Avaliação dos seguintes parâmetros: tipo de suporte para o paciente, tempo de cirurgia, índice de massa corporal. Resultados Foram feitas 367 cirurgias por via posterior da coluna lombar para patologias degenerativas da coluna lombar. A MP foi observada em 81 pacientes (22%). Em 65 pacientes (80%), houve resolução completa dos sintomas com manejo conservador (medidas locais e medicamentos para dor neuropática) em menos de dois meses. Doze pacientes melhoraram através de infiltração com corticoide de depósito e anestésico no local no ligamento inguinal e, em quatro pacientes houve necessidade de procedimento cirúrgico no terceiro mês. O suporte pneumático foi o menos envolvido no desenvolvimento da MP, assim como o tempo cirúrgico <1h e índice de massa corporal <25. Conclusão A MP refratária pode ocorrer em pacientes submetidos a cirurgias na coluna lombar por via posterior. O manejo inclui medidas locais, medicamentos para dor neuropática e infiltração com corticoide no ligamento inguinal. A cirurgia descompressiva está reservada para os raros casos refratários. Nível de evidência III; Estudo prospectivo observacional com série de casos comparativos.
RESUMEN Objetivo El objetivo del presente estudio consiste en relatar la experiencia de 5 años en el reconocimiento y manejo de la meralgia parestésica (MP) refractaria en pacientes sometidos a cirugías lumbares por vía posterior. Métodos Pacientes sometidos a procedimientos en la columna lumbar, en el período de enero de 2010 a enero de 2015, en tres diferentes centros hospitalarios de Belo Horizonte/MG, fueron seleccionados para evaluación del desarrollo de la MP postoperatoria. Estudio prospectivo observacional con serie de casos comparativos. Nivel III de evidencia. Evaluación de los siguientes parámetros: tipo de soporte para el paciente, tiempo de cirugía, índice de masa corporal. Resultados Se realizaron 367 cirugías por vía posterior de la columna lumbar para patologías degenerativas de la columna lumbar. La MP fue observada en 81 pacientes (22%). En 65 pacientes (80%) hubo resolución completa de los síntomas con manejo conservador (medidas locales y medicamentos para el dolor neuropático) en menos de 2 meses. Doce pacientes mejoraron a través de infiltración de corticoide de depósito y anestésico en el local en el ligamento inguinal y, en cuatro pacientes, hubo necesidad de procedimiento quirúrgico en el tercer mes. El soporte neumático fue el menos involucrado en el desarrollo de la MP, así como el tiempo quirúrgico <1h e índice de masa corporal <25. Conclusión La MP refractaria puede ocurrir en pacientes sometidos a cirugías en la columna lumbar por vía posterior. El manejo incluye medidas locales, medicamentos para el dolor neuropático e infiltración con corticoide en el ligamento inguinal. La cirugía descompresiva está reservada para los raros casos refractarios. Nivel de evidencia III; Estudio prospectivo observacional con serie de casos comparativos.
Subject(s)
Humans , General Surgery , Low Back Pain , Femoral Neuropathy , Lumbosacral RegionABSTRACT
Background and Objectives: The lateral femoral cutaneous nerve (LFCN) of the thigh arises from the dorsalbranches of the second and third lumbar ventral rami. Several variations in the formation, course and branchesof this nerve have been reported. The regional anatomy of the lateral femoral cutaneous nerve is highly variedand may account for its susceptibility to local trauma. Knowledge of these variations is important for surgeonsto avoid injury to the nerve. The aim of this study was to evaluate the variations in the formation of LFCN of thethigh and to discuss its clinical implications.Materials And Methods: The study was conducted on 25(50 sides) adult human cadavers in the Department ofAnatomy, Sri Siddhartha Medical College, Tumkur, Karnataka, India by dissection method. The LFCN was lookedfor, bilaterally, and its formation studied. The specimens were numbered and photographed.Results: In the present study, the lateral femoral cutaneous nerve of thigh arising from dorsal divisions of L2 L3was observed in 34(68%) specimens. Variations in LFCN were observed in 16 specimens. The variationsencountered were the absence of LFCN (2%), the origin of LFCN from ventral ramus of L1 spinal nerve (2%), theorigin of LFCN from ventral rami of L1 L2 spinal nerves (8%), the origin of LFCN as a branch of femoral nerve (20%).Conclusion: The present study highlights the necessity for a thorough knowledge of the topographical features ofthe LFCN so as to increase the efficacy of diagnosis, reduce complications and increase patient comfort.
ABSTRACT
Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femoral cutaneous nerve (LFCN) of thigh. Patients refractory to conservative management are treated with various interventional procedures. We report the first use of extended duration (8 minutes) pulsed radiofrequency of the LFCN in a case series of five patients with refractory MP. Four patients had follow up for 1–2 years, and one had 6 months follow up. All patients reported remarkable and long lasting symptom relief and an increase in daily life activities. Three patients came off medications and two patients required minimal doses of neuropathic medications. No complications were observed.
Subject(s)
Humans , Analgesia , Catheter Ablation , Chronic Pain , Follow-Up Studies , Mononeuropathies , Neuralgia , Pain Management , Pulsed Radiofrequency Treatment , ThighABSTRACT
Meralgia paresthetica (MP) is a sensory mononeuropathy of the lateral femoral cutaneous nerve (LFCN). MP has rarely been reported after a femoral intervention approach. We report a case of bilateral meralgia paresthetica following bilateral femoral cannulation. A 64-year-old male received cardiac catheterization and treatment via a bilateral femoral vein. After cardiac catheterization, the patient presented with paresthesia in the anterolateral aspect of the bilateral thigh. After performing nerve conduction studies and electromyography, he was diagnosed as MP. Although a bilateral LFCN lesion following a femoral approach is very rare, MP might require caution regarding potential variations in LFCN when performing the femoral approach.
Subject(s)
Humans , Male , Middle Aged , Cardiac Catheterization , Cardiac Catheters , Catheterization , Electromyography , Femoral Vein , Mononeuropathies , Neural Conduction , Paresthesia , ThighABSTRACT
Meralgia paresthetica (MP) is a painful mononeuropathy of the lateral femoral cutaneouse nerve (LFCN) characterized by localized symptoms of numbness, tingling, pain and paresthesia along the anterolateral thigh area. L4 and L5 radiculopathy is set of symptoms that include sharp, burning or shooting pain, which is usually localized to anterolateral leg area and along the dermatomal distribution. When symptoms of MP and lumbar disc disease occur together it is not easy to diagnose MP. We report a case of synchronous post-traumatic MP and radiculopathy due to intervertebral disc herniation at L3–4 and 4–5. A 59-year-old male patient was admitted to the emergency room with symptoms of low back pain with left severe L4, L5 radiculopathy. This patient also complained of numbness and paresthesia in the left anterolateral thigh. After detailed history taking and lateral femoral cutaneouse nerve block, he was diagnosed with MP.
Subject(s)
Humans , Male , Middle Aged , Burns , Emergency Service, Hospital , Hypesthesia , Intervertebral Disc , Leg , Low Back Pain , Mononeuropathies , Nerve Block , Paresthesia , Radiculopathy , ThighABSTRACT
Meralgia paresthetica is a lateral femoral cutaneous neuropathy that results in symptoms of anterolateral thigh paresthesia and numbness. Its presentation due to compression of a thoraco-lumbo-sacral-orthosis (TLSO) has not been reported. We experienced a case of a 67-year-old woman who developed left lateral femoral cutaneous neuropathy as a complication of inaccurate wearing of a TLSO. The patient suffered from tingling sensation and pain in the anterolateral aspect of the left thigh without muscular weakness. An electrodiagnostic study revealed a conduction block in the left lateral femoral cutaneous nerve (LFCN) around the inguinal ligament. Ultrasonography revealed swelling of the left LFCN compared with the right side. The patient's symptoms improved after she ceased wearing the TLSO and received conservative care. Considering the complications can develop after wearing spinal orthosis, we suggest that orthosis be prescribed accurately and inspected meticulously by experts physician.
Subject(s)
Aged , Female , Humans , Hypesthesia , Ligaments , Muscle Weakness , Orthotic Devices , Paresthesia , Sensation , Thigh , UltrasonographyABSTRACT
BACKGROUND: Meralgia paresthetica (MP) is a mononeuropathy affecting the lateral femoral cutaneous nerve. The disease is often diagnosed clinically, but electrophysiological tests play an important role. The aim of this study is to clarify clinical characteristics of MP as well as the role of sensory nerve conduction study (NCS) in the diagnosis of MP. METHODS: Sixty-five consecutive patients with clinical diagnosis of MP between March 2001 and June 2012 were retrospectively reviewed at a single tertiary center. General demographics, clinical characteristics and sensory NCS findings were investigated. Measurements of sensory NCS included the baseline-to-peak amplitude, side-to-side amplitude ratio and the conduction velocity. To compare between the normal and abnormal NCS groups, independent t-tests and chi-square test were performed. RESULTS: Sixty-five patients had male predominance (56.9%) with mean age of 48.4+/-13.4 years (range: 16-75). Seven patients (13.5%) had undergone operation or procedure before the symptom onset. The sensory nerve action potentials were obtainable in 52 (80%) of 65 clinically diagnosed MP patients. Sensory NCS revealed abnormalities in 38 patients (73.1%), and others (n=14, 26.9%) showed normal findings. Between the normal and abnormal NCS groups, there is no statistically significant difference on demographics or clinical features. CONCLUSIONS: We clarify the clinical features and sensory NCS findings of MP patients. Due to several limitations of sensory NCS, the diagnosis of MP could be accomplished both clinically and electrophysiologically.
Subject(s)
Humans , Male , Action Potentials , Chi-Square Distribution , Demography , Diagnosis , Mononeuropathies , Neural Conduction , Retrospective StudiesABSTRACT
OBJECTIVE: Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. METHODS: During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. RESULTS: Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. CONCLUSION: Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.
Subject(s)
Humans , Consensus , Decompression , Electrodiagnosis , Fascia , Follow-Up Studies , Ligaments , Nerve Compression Syndromes , Paresthesia , Recurrence , Retrospective Studies , ThighABSTRACT
Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9x5x4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence.
Subject(s)
Adolescent , Humans , Decompression, Surgical , Electromyography , Femoral Neuropathy , Follow-Up Studies , Hematoma , Hypesthesia , Leg , Needles , Nerve Compression Syndromes , Neural Conduction , Pelvic Bones , Regeneration , ThighABSTRACT
Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.
Subject(s)
Ligaments , Mononeuropathies , Nerve Block , Nerve Compression Syndromes , Organic Chemicals , Paresthesia , Peripheral Nerves , Spine , Sural NerveABSTRACT
We describe a rare case of pulsed radiofrequency treatment for pain relief associated with meralgia paresthetica. A 58-year-old female presented with pain in the left anterior lateral thigh. An imaging study revealed no acute lesions compared with a previous imaging study, and diagnosis of meralgia paresthetica was made. She received temporary pain relief with lateral femoral cutaneous nerve blocks twice. We performed pulsed radiofrequency treatment, and the pain declined to 25% of the maximal pain intensity. At 4 months after the procedure, the pain intensity did not aggravate without medication. Pulsed radiofrequency neuromodulation treatment on the lateral femoral cutaneous nerve may offer an effective, low risk treatment in patients with meralgia paresthetica who are refractory to conservative medical treatment.
Subject(s)
Female , Humans , Middle Aged , Nerve Block , Nerve Compression Syndromes , Pulsed Radiofrequency Treatment , ThighABSTRACT
Meralgia paresthetica is commonly caused by a focal entrapment of lateral femoral cuteneous nerve while it passes the inguinal ligament. Common symptoms are paresthesias and numbness of the upper lateral thigh area. Pregnancy, tight cloths, obesity, position of surgery and the tumor in the retroperitoneal space could be causes of meralgia paresthetica. A 29-year-old female patient underwent an emergency cesarean section under spinal anesthesia without any problems. But two days after surgery, the patient complained numbness and paresthesia in anterolateral thigh area. Various neurological examinations and L-spine MRI images were all normal, but the symptoms persisted for a few days. Then, electromyogram and nerve conduction velocity test of the trunk and both legs were performed. Test results showed left lateral cutaneous nerve injury and meralgia paresthetica was diagnosed. Conservative treatment was implemented and the patient was free of symptoms after 1 month follow-up.
Subject(s)
Adult , Female , Humans , Pregnancy , Anesthesia, Spinal , Cesarean Section , Emergencies , Follow-Up Studies , Hypesthesia , Leg , Ligaments , Nerve Compression Syndromes , Neural Conduction , Neurologic Examination , Obesity , Paresthesia , Retroperitoneal Space , ThighABSTRACT
Lateral femoral cutaneous neuropathy occurring during spinal surgery is frequently related to iliac bone graft harvesting, but meralgia paresthetica (MP) can result from the patient being in the prone position. Prone position-related MP is not an uncommon complication after posterior spine surgery but there are only few reports in the literature on this subject. It is usually overlooked because of its mild symptoms and self-limiting course, or patients and physicians may misunderstand the persistence of lower extremity symptoms in the early postoperative period to be a reflection of poor surgical outcome. The authors report a case of prone position-related MP after posterior lumbar interbody fusion at the L3-4 and reviewed the literature with discussion on the incidence, pathogenesis, and possible risk factors related to this entity.
Subject(s)
Humans , Incidence , Lower Extremity , Nerve Compression Syndromes , Postoperative Period , Prone Position , Risk Factors , Spine , TransplantsABSTRACT
OBJECTIVE: Lateral femoral cutaneous nerve (LFCN) conduction study is an objective measure for the diagnosis of meralgia paresthetica. Sensory nerve action potential of LFCN is not frequently evoked because of anatomical variations around inguinal area. The purpose of this study is to support the diagnosis of meralgia paresthetica by considering anatomical variations of LFCN in Korean adult cadavers. METHOD: Eighteen lower limbs of total nine adult cadavers were studied. Men were five and women were four. The points that LFCN or the main branch of LFCN met the imaginary line from anterior superior iliac spine (ASIS) to pubic tubercle and to lateral border of patella were recorded, respectively and distances from ASIS to those points were measured. RESULTS: The distance from ASIS to the point that LFCN or the main branch of LFCN met the imaginary line from ASIS to pubic tubercle and to lateral border of patella was respectivlely 1.36+/-0.68 cm (minimal 0.2, maximal 3.0) and 10.74+/-5.68 (minimal 3.3, maximal 20.1) cm. There was no significant distance difference between men and women. CONCLUSION: This study showed anatomic variations of LFCN around ASIS and femoral part. This knowledge may help LFCN conduction study for the diagnosis of meralgia paresthetica.
Subject(s)
Adult , Female , Humans , Male , Action Potentials , Cadaver , Diagnosis , Lower Extremity , Neural Conduction , Patella , SpineABSTRACT
OBJECTIVE: Meralgia Paresthetica is an entrapment neuropathy involving the lateral femoral cutaneous nerve. The aim of the present study is to evalute results of two surgical procedures(neurolysis and transection) for this disease. METHODS: The authors reviewed the 11 patients who underwent surgery in our hospital for meralgia paresthetica for last 15 years. Preoperatively all patients were treated by conservative management which was failed. Visual analogue scale(VAS) sore was used for pre-and post-operative assessments of the pain. Operation is performed by infrainguinal ligament approach. Nine patients underwent neurolysis, and two patients underwent transection of the lateral femoral cutaneous nerve. The average follow-up period was 14.3 months. RESULTS: In 10 cases good relief of symptom was obtained, but in one case relief of symptom was not. Superior result of transection as a treatment for meralgia paresthetica was obtained. But, there was no statistically significant difference between two procedures because of small group. CONCLUSION: When surgery is indicated for patients in whom pain is severe and persistent despite adequate conserative management, it appears to offer good results.
Subject(s)
Humans , Follow-Up Studies , LigamentsABSTRACT
We present a patient with meralgia paresthetica by a distended iliopsoas bursa and associated with concurrent osteonecrosis of the femoral head. This manifestation is unusual and extremely rare because classically LFCN dose not pass near the iliopsoas bursa. We presume a mechanism of nerve injury by variation of the course of lateral femoral cutaneous nerve.
Subject(s)
Humans , Head , OsteonecrosisABSTRACT
BACKGROUND: Meralgia paresthetica(MP) which is characterized by paresthesias and sensory impairment without motor weakness in the anterolateral aspects of the thighis produced by compression of the lateral femoral cutaneous nerve(LFCN). Even though the diagnosis of MP is mostly based on the clinical symptoms, electrophysiologic study is mandatory to confirm the disease objectively. It has been known that Somatosensory evoked potential(SSEP) study of LFCN is a simple and very useful method to evaluate MP, so we studied SSEP of LFCN in normal adults and offer normal values. MATERIALS AND METHODS: Thirty six normal adults(23 males and 13 females) ages from 21 to 73 years old(mean+/-SD:42.06+/-15.74) were studied SSEP of LFCN bilaterally. The stimulation site was anterolateral aspect of thighs and the recording site was Cz'. RESULTS: The mean values(msec+/-SD) of LPo, SPdegree, LN, and SN1 of all subjects were 35.10(+/-2.42), 33.80(+/-2.4), 43.68(+/-1.88) and 42.16(+/-2.12) and the mean values(msec+/- SD) of DPo, DNl and DA(tw+/-SD) were 1.3O(fi1.14), 1.52(+/-1.38) and 0.32(+/-0.33). CONCLUSION: For the diagnosis of MP, comparison of latency difference between both sides is more reliable than simple value of latency itself because of individual differences of body types. According to our results, the latency difference should be less than 2 msec and the amplitude difference was less than 1.6 times in normal adults.
Subject(s)
Adult , Humans , Male , Diagnosis , Evoked Potentials, Somatosensory , Individuality , Paresthesia , Reference Values , Somatotypes , ThighABSTRACT
OBJECTIVE: To evaluate the relationship between postoperative sensory change on lower extremities and clinical factors associated with gynecologic operation. METHODS: We retrospectively reviewed 38 cases of patients with postoperative complaints of pain or dysthesis on lower extremities, especially anterolateral thigh from March 1993 through December 1999 at Gyeongsang National University Hospital, Department of Obstetrics and Gynecology. The electromyography (EMG) and nerve conduction velocity (NCV) were performed in all 38 patients. According to the result of EMG and NCV, patients were divided into control group (n=28) which in that with normal finding in electrodiagnosis and study group (n=10) who showed femoral cutaneous nerve injury in electrodiagnosis. Clinical characteristics (age, height, weight and operative history), operative methods, skin incisional method, operative time and postoperative diagnosis were reviewed in each group. RESULTS: There were significant differences in patient's body weight, height, skin incisional method and operative method between control and study group. Height was 152.5cm [150.3-155.6] in study group and 157.5cm [153.4-159.2] in control group (p-value = 0.020). Weight was 46.9kg [43.4-58.0] in study group and 57.0kg [54.4-58.1] in control group (p-value=0.004). Skin incisional method in study group was done by 6 cases (60%) of infraumbilical mid-line vertical incision and in control group by 5 cases (17.9%) (p-value = 0.019). In operative method, radical hysterectomy was 4 cases (40%) in study group and 2 cases (7.1%) in control group (p-value=0.031). But no correlation was observed in post-operative diagnosis, operative time, blood loss and transfusion between two groups. CONCLUSION: It was suggested that Lateral femoral cutaneous nerve was compressed by pelvic retractor during the gynecologic operation. Patient's body weight, height, skin incisional method and operative method may play a role of compressive factor on Lateral femoral cutaneous nerve, increasing Meralgia Paresthetica.
Subject(s)
Humans , Body Weight , Diagnosis , Electrodiagnosis , Electromyography , Gynecology , Hysterectomy , Lower Extremity , Neural Conduction , Obstetrics , Operative Time , Retrospective Studies , Skin , ThighABSTRACT
BACKGROUND: Meralgia paresthetica(MP) is clinically benign entrapment neuropathy which is characterized by paresthesias and sensory impairment in the cutaneous distribution of the lateral femoral cutaneous nerve(LFCN). The diagnosis of MP is mostly based on clinical symptoms. Sensory nerve conduction study of the LFCN have been of limited value because frequently they could not be recorded in able-bodied persons and also because lesions of the nerve may be localized proximally from the segment that is accessible to nerve conduction study. For these reasons, I studied simple bilateral somatosensory evoked potentials(SSEP) of LFCN to evaluate this clinical symptoms objectively. METHODS: 16 MP patients (mean age+/-SE : 50+/-3.21yrs) and 15 disease free adults(49+/-4.47yrs) were studied bilateral SSEP of LFCN. The stimulation site was anterolateral aspect of thigh and the recording site was Cz'. RESULTS: The mean latencies of P0 and N1 were prolonged on the affected side(P<0.05), The mean latency differences of P0 and N1 between two sides were increased in the patients with MP compare with those of controls.(P<0.001) The mean amplitude difference between two sides were increased in the patients with MP compare with that of controls(P<0.05). CONCLUSION: SSEP of LFCN can be used as a objective test to support the diagnosis of MP. I suggest more than 2.4msec difference for P0 latency between affected and unaffected side could be abnormal.
Subject(s)
Humans , Diagnosis , Evoked Potentials , Evoked Potentials, Somatosensory , Neural Conduction , Paresthesia , ThighABSTRACT
Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, of the anterolateral thigh caused by entrapment or metabolic neuropathy of the lateral femoral cutaneous nerve. Many cases of meralgia paresthetica have been presented for a century. We have experienced a case of meralgia paresthetica which was misdiagnosed as lumbar radicu- lopathy at other hospital, of a 53-year-old man who had developed painful paresthesia and dysesthe- sia of the anterolateral thigh caused by soft tissue tuberculosis of oblique abdominal muscles just proximal to the lateral inguinal ligament where the lateral femoral cutaneous nerve passes. We report a case of unilateral meralgia paresthetica secondary to soft tissue tuberculosis with review of literatures because it has not previously been reported.