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1.
Coluna/Columna ; 19(1): 40-43, Jan.-Mar. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1089644

RESUMEN

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.


Asunto(s)
Humanos , Cirugía General , Dolor de la Región Lumbar , Neuropatía Femoral , Región Lumbosacra
2.
Acta Anatomica Sinica ; (6): 416-419, 2020.
Artículo en Chino | WPRIM | ID: wpr-1015564

RESUMEN

Objective Meralgia paresthetica(MP) is commonly caused by mechanical entrapment of the lateral femoral cutaneous nerve (LFCN). The entrapment often occurs at the site where the nerve exits the pelvis. Its optimal surgical management remains to be established, partly because the fine architecture of the fascial planes around the lateral femoral cutaneous nerve has not been elucidated. The purpose of this study is to determine the fascia structure of lateral femoral cutaneous nerve nearby the anterior superior iliac spine using anatomy and ultrasound technique. Methods Eleven cadavers were selected for plastination (6 female, 5 male, age range 38-97 years). Ultrasonography was performed on 34 healthy volunteers (19 women, 15 men, age range, 20-62 years). Results The lateral femoral cutaneous nerve exited the pelvis via a tendinous canal within the internal oblique-iliac fascia septum,and then between the sartorius muscle surface and the tensor fascia lata muscle located below the anterior superior iliac spine (ASIS). and then ran between the sartorius muscle and the tensor fascia. Conclusion Lateral femoral cutaneous nerve is located in the aponeurosis of the intra-abdominal oblique muscle at the pelvic outlet. Lateral femoral cutaneous nerve travels on the surface and outside of the sartorius muscle. These two segments of lateral femoral cutaneous nerve can be localized by ultrasound scans.

3.
Artículo | IMSEAR | ID: sea-198433

RESUMEN

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.

4.
The Korean Journal of Pain ; : 215-220, 2018.
Artículo en Inglés | WPRIM | ID: wpr-742185

RESUMEN

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.


Asunto(s)
Humanos , Analgesia , Ablación por Catéter , Dolor Crónico , Estudios de Seguimiento , Mononeuropatías , Neuralgia , Manejo del Dolor , Tratamiento de Radiofrecuencia Pulsada , Muslo
5.
Neurointervention ; : 122-124, 2017.
Artículo en Inglés | WPRIM | ID: wpr-730355

RESUMEN

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.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Cateterismo Cardíaco , Catéteres Cardíacos , Cateterismo , Electromiografía , Vena Femoral , Mononeuropatías , Conducción Nerviosa , Parestesia , Muslo
6.
Korean Journal of Dermatology ; : 198-202, 2017.
Artículo en Coreano | WPRIM | ID: wpr-53857

RESUMEN

Notalgia paresthetica (NP) is a chronic localized itch, affecting mainly the inter-scapular area particularly between the T2-T6 dermatomes. Occasionally it has a more widespread distribution and involves the shoulders, back, and upper chest. There are no specific cutaneous signs, apart from those attributed to scratching and rubbing. Various etiologies have been reported, but the cause of NP is not established. The current hypothesis regarding its etiology postulates that a neuropathic itch develops due to nerve entrapment of the posterior rami of spinal nerve arising at T2-T6. Another recent documented case showed an increase in the number of intradermal nerves by neural immunochistochemistry staining of S-100 protein, protein gene product 9.5 (PGP 9.5). Herein, we experienced an uncommon case of NP of the back and tried to clarify pathogenesis by using quantitative sensory testing, such as neurometer and Von-Frey filaments. Also, we performed neural immunochemistry to confirm an increase in nerve fibers at the site of the lesion.


Asunto(s)
Inmunoquímica , Síndromes de Compresión Nerviosa , Fibras Nerviosas , Pregabalina , Proteínas S100 , Hombro , Nervios Espinales , Tórax
7.
Anesthesia and Pain Medicine ; : 81-84, 2017.
Artículo en Inglés | WPRIM | ID: wpr-21258

RESUMEN

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.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Quemaduras , Servicio de Urgencia en Hospital , Hipoestesia , Disco Intervertebral , Pierna , Dolor de la Región Lumbar , Mononeuropatías , Bloqueo Nervioso , Parestesia , Radiculopatía , Muslo
8.
Annals of Dermatology ; : 86-89, 2016.
Artículo en Inglés | WPRIM | ID: wpr-223547

RESUMEN

Notalgia paresthetica (NP) is a focal neuropathic itch condition manifesting in intense chronic or recurrent episodic itch in a hyperpigmented, macular, uni- or bilateral skin area located below and/or medially to the scapulae. Achieving satisfactory relieve in NP patients is challenging. In this case-series three female NP patients were treated with 8% capsaicin patches following a spatial quantification of their alloknetic area with a von Frey filament. The use of a von Frey filament in order to delimit the precise area of itch sensitization and thus patch application, proved clinically feasible. Although 8% topical capsaicin relieved itch in all three patients, the duration of the effectiveness varied greatly from only 3 days to >2 months. The treatment was well tolerated in the patients and there appear to be no significant hindrances to applying this treatment with NP as an indication, although it may only exhibit satisfactory effectiveness in certain patients. Placebo-controlled double-blinded trials are needed to confirm the effectiveness of the treatment and assess predictive parameters of the treatment outcome.


Asunto(s)
Femenino , Humanos , Capsaicina , Parestesia , Prurito , Escápula , Piel , Resultado del Tratamiento
9.
Keimyung Medical Journal ; : 219-225, 2015.
Artículo en Coreano | WPRIM | ID: wpr-12447

RESUMEN

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.


Asunto(s)
Anciano , Femenino , Humanos , Hipoestesia , Ligamentos , Debilidad Muscular , Aparatos Ortopédicos , Parestesia , Sensación , Muslo , Ultrasonografía
10.
Korean Journal of Clinical Neurophysiology ; : 48-52, 2013.
Artículo en Inglés | WPRIM | ID: wpr-50537

RESUMEN

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.


Asunto(s)
Humanos , Masculino , Potenciales de Acción , Distribución de Chi-Cuadrado , Demografía , Diagnóstico , Mononeuropatías , Conducción Nerviosa , Estudios Retrospectivos
11.
Journal of the Korean Society of Emergency Medicine ; : 241-245, 2013.
Artículo en Coreano | WPRIM | ID: wpr-37226

RESUMEN

Meralgia paresthetica (MP), first described in 1878, is a sensory mononeuropathy of the lateral femoral cutaneous nerve (LFCN) characterized by pain, tingling, numbness, and paresthesias localized to the anterolateral thigh. There are many etiologies for MP, including those that are spontaneous (idiopathic, metabolic or mechanical) and iatrogenic (surgery, trauma). A 46-year-old female came to our emergency department (ED) with a right hip pain that developed after two days of an altered mental status from high amounts of multiple drugs (benzodiazepine, SSRI, and antipsychotics) to commit suicide. Her past medical and surgical histories were unremarkable. In addition, her vital signs were stable and her electrocardiography was unremarkable. On the other hand, laboratory tests showed an elevated creatinine kinase 14787 IU/L (normal range, 26~140 IU/L) and urine myoglobin >1000 ng/mL (normal range, 0~10 ng/mL). She was admitted to our ED for the management of rhabdomyolysis. The patient didn't slip down and slept on her right side for a long period. An initial pelvis and femur x-ray ruled out a fracture and a straight leg raise test was negative. We took a lumbar spine x-ray to rule out a herniated intervertebral disk because she complained of pain in the second and third lumbar distribution of her right thigh. These x-rays were unremarkable. We presumed she had a hip and thigh contusion and gave her painkillers, but her symptoms did not improved. After a day, the patient complained of numbness (5/10) rather than pain. We then suspected peripheral neuropathy. Her electromyography and nerve conduction velocity confirmed right LFCN neuropathy, MP. MP is often clinically diagnosed and treated conservatively. It is a neurologic disorder due to the entrapment of the LFCN. This case shows that a long period lacking in movement can cause MP. In future cases, the possibility of peripheral neuropathy should be considered, especially in mentally altered patients after drug intoxication.


Asunto(s)
Femenino , Humanos , Contusiones , Creatinina , Electrocardiografía , Electromiografía , Urgencias Médicas , Fémur , Mano , Cadera , Hipoestesia , Disco Intervertebral , Pierna , Mononeuropatías , Mioglobina , Síndromes de Compresión Nerviosa , Enfermedades del Sistema Nervioso , Conducción Nerviosa , Parestesia , Pelvis , Enfermedades del Sistema Nervioso Periférico , Fosfotransferasas , Porfirinas , Columna Vertebral , Suicidio , Muslo , Signos Vitales
12.
Journal of Korean Neurosurgical Society ; : 363-366, 2012.
Artículo en Inglés | WPRIM | ID: wpr-202351

RESUMEN

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.


Asunto(s)
Humanos , Consenso , Descompresión , Electrodiagnóstico , Fascia , Estudios de Seguimiento , Ligamentos , Síndromes de Compresión Nerviosa , Parestesia , Recurrencia , Estudios Retrospectivos , Muslo
13.
Annals of Rehabilitation Medicine ; : 273-277, 2012.
Artículo en Inglés | WPRIM | ID: wpr-72468

RESUMEN

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.


Asunto(s)
Adolescente , Humanos , Descompresión Quirúrgica , Electromiografía , Neuropatía Femoral , Estudios de Seguimiento , Hematoma , Hipoestesia , Pierna , Agujas , Síndromes de Compresión Nerviosa , Conducción Nerviosa , Huesos Pélvicos , Regeneración , Muslo
14.
The Korean Journal of Pain ; : 115-118, 2011.
Artículo en Inglés | WPRIM | ID: wpr-207813

RESUMEN

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.


Asunto(s)
Ligamentos , Mononeuropatías , Bloqueo Nervioso , Síndromes de Compresión Nerviosa , Compuestos Orgánicos , Parestesia , Nervios Periféricos , Columna Vertebral , Nervio Sural
15.
Journal of Korean Neurosurgical Society ; : 151-153, 2011.
Artículo en Inglés | WPRIM | ID: wpr-145216

RESUMEN

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.


Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Bloqueo Nervioso , Síndromes de Compresión Nerviosa , Tratamiento de Radiofrecuencia Pulsada , Muslo
16.
Rev. argent. dermatol ; 91(4): 10-14, dic. 2010. ilus
Artículo en Español | LILACS | ID: lil-634418

RESUMEN

A case of a patient with psoriasis whose lesions resemble notalgia paresthetica is reported. We propose this association can involve important clinical and therapeutic factors to be taken into a count.

17.
Korean Journal of Anesthesiology ; : S86-S89, 2010.
Artículo en Inglés | WPRIM | ID: wpr-168073

RESUMEN

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.


Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Anestesia Raquidea , Cesárea , Urgencias Médicas , Estudios de Seguimiento , Hipoestesia , Pierna , Ligamentos , Síndromes de Compresión Nerviosa , Conducción Nerviosa , Examen Neurológico , Obesidad , Parestesia , Espacio Retroperitoneal , Muslo
18.
Rev. chil. dermatol ; 24(2): 132-134, 2008. ilus, tab
Artículo en Español | LILACS | ID: lil-567053

RESUMEN

La notalgia parestésica es una neuropatía sensorial caracterizada clínicamente por una mancha hiperpigmentada bien circunscrita localizada en la espalda, que afecta las áreas correspondientes a los dermatomos D2 a D6. El prurito es el síntoma más común, aunque algunos pacientes describen otras sensaciones, incluyendo ardor, parestesia, hiperestesia o dolor. Los hallazgos histopatológicos son inespecíficos. Su etiología no ha sido claramente demostrada, pero en algunos casos existe una llamativa correlación con patología de la columna vertebral, incluyendo cambios degenerativos y/o hernias del núcleo pulposo. El diagnóstico diferencial incluye la neurodermitis y la amiloidosis macular. No existe un tratamiento definitivo para la enfermedad. Se han empleado diversas terapias incluyendo capsaicina tópica, bloqueo anestésico para vertebral, oxcarbazepina, gabapentina y toxina botulínica.


Notalgia paresthetica is a sensory neuropathy characterizd clinically by a well-circumscribed hyperpigmented patch located on the back, affecting the areas corresponding to dermatomes D2-D6. Pruritus is its most common symptom, but some patients describe other sensations including burning, paresthesia, hypeesthesia or pain. Histopathological findings are not specific. The etiology of this condition has not be en clearly demonstrated but in some cases there exists a striking correlation with spinal pathology, including degenerative changes or a herniated nucleous pulposus. Differential diagnoses include neurodermitis and maclular amyloidosis There is no definitive treatment for the disease diverse therapies have been employed including topical capsaicin paravertebral local anesthetic block, oxcarbazepine, gabapentir and botulinum toxin type A.


Asunto(s)
Humanos , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/tratamiento farmacológico , Parestesia/diagnóstico , Parestesia/tratamiento farmacológico , Anticonvulsivantes/uso terapéutico , Capsaicina/uso terapéutico , Diagnóstico Diferencial , Dolor de Espalda/etiología , Enfermedades de la Piel/etiología , Enfermedades de la Piel/patología , Hiperpigmentación , Parestesia/etiología , Parestesia/patología , Toxinas Botulínicas/uso terapéutico
19.
Journal of Korean Neurosurgical Society ; : 392-395, 2008.
Artículo en Inglés | WPRIM | ID: wpr-184104

RESUMEN

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.


Asunto(s)
Humanos , Incidencia , Extremidad Inferior , Síndromes de Compresión Nerviosa , Periodo Posoperatorio , Posición Prona , Factores de Riesgo , Columna Vertebral , Trasplantes
20.
Journal of the Korean Academy of Rehabilitation Medicine ; : 614-618, 2005.
Artículo en Coreano | WPRIM | ID: wpr-723819

RESUMEN

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.


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Potenciales de Acción , Cadáver , Diagnóstico , Extremidad Inferior , Conducción Nerviosa , Rótula , Columna Vertebral
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