Meralgia Paresthetica Clinical Presentation
- Author: Elizabeth A Sekul, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE more...
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- When the LFCN is entrapped, paresthesias and numbness of the upper lateral thigh area are the presenting symptoms. The paresthesias may be quite painful.
- Symptoms are typically unilateral. However, they may be bilateral in up to 20% of cases.
- Walking or standing may aggravate the symptoms; sitting tends to relieve them.
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- Examination reveals numbness of the anterolateral thigh in all or part of the area involved with the paresthesias.
- Occasionally, patients are hyperesthetic in this area.
- Tapping over the upper and lateral aspects of the inguinal ligament or extending the thigh posteriorly, which stretches the nerve, may reproduce or worsen the paresthesias.
- Deep palpation just below the anterior superior iliac spine (pelvic compression testing) reproduces the symptoms. A study in 45 patients found that the pelvic compression test had a sensitivity of 95% and a specificity of 93.3% for meralgia paresthetica.
- Motor strength in the involved leg should be normal.
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- Lying in the fetal position for prolonged periods also has been implicated, as has prone positioning after lumbar spinal surgery.
- Meralgia paresthetica is more common in diabetics than in the general population.
- Although rare, impingement of the LFCN by masses (eg, neoplasms, contained iliopsoas hemorrhages) in the retroperitoneal space before it reaches the inguinal ligament can cause the same symptoms.
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