Meralgia Paresthetica

Meralgia Paresthetica is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Meralgia paresthetica (MP) describes an entrapment of the lateral femoral cutaneous nerve (LFCN).
  • Symptoms include pain, paresthesias, and sensory loss over the anterolateral aspect of the thigh (1).

Epidemiology

Incidence
  • MP occurs most commonly in 30- to 40-year-olds but may affect any age group (1).
  • General population incidence: 4.3/10,000 patient-years (2)
  • Retrospective study from Minneapolis observed that patients with diabetes have 7-fold increase incidence (3).

Etiology and Pathophysiology

MP arises from LFCN entrapment.

  • LFCN is usually derived from L1, L2, and L3 nerve roots.
  • LFCN emerges from the lateral aspect of the psoas muscle and travels along the retroperitoneal space toward the anterior superior iliac spine (ASIS). It enters the anterior region of the thigh by passing deep to, through, or superficial to the inguinal ligament.
  • Most commonly entrapped at inguinal ligament but may occur at any place along course of LFCN

Risk Factors

  • Iatrogenic: common postsurgical complication after hip replacement, pelvic, or spine surgeries
  • Metabolic factors: diabetes, obesity, alcoholism, heavy metal poisoning
  • Mechanical factors: tight clothing/belts around waist, pregnancy, seatbelts, strenuous walking/cycling (2)

Commonly Associated Conditions

  • Pregnancy
  • Obesity
  • Sudden weight changes (up or down)
  • Hip osteoarthritis or pubic symphysis degeneration
  • Hip, pelvic, or spine surgical history
  • Retroperitoneal/pelvic mass
  • Carpal tunnel syndrome (2)

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