Meralgia Paresthetica

Author: Elizabeth A Sekul; Chief Editor: Nicholas Lorenzo, MD more...

Updated: Feb 3, 2012

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Background
Pathophysiology
Epidemiology
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Background

A painful mononeuropathy of the lateral femoral cutaneous nerve (LFCN), meralgia paresthetica is commonly due to focal entrapment of this nerve as it passes through the inguinal ligament. Rarely, it has other etiologies such as direct trauma, stretch injury, or ischemia. It typically occurs in isolation. The clinical history and examination is usually sufficient for making the diagnosis. However, the diagnosis can be confirmed by nerve conduction studies. Treatment is usually supportive. The LFCN is responsible for the sensation of the anterolateral thigh. It is a purely sensory nerve and has no motor component.^[1]

Pathophysiology

Reviewing the anatomy of the LFCN is essential for understanding the mechanism of its injury (see the images below). The LFCN originates directly from the lumbar plexus and has root innervation from L2-3. The nerve runs through the pelvis along the lateral border of the psoas muscle to the lateral part of the inguinal ligament. Here, it passes to the thigh through a tunnel formed by the lateral attachment of the inguinal ligament and the anterior superior iliac spine. The crossover into the thigh is the most common site of entrapment. The crossover typically occurs 1 cm medial to the anterior superior iliac spine; however, regional variations are common.^[2]

Anatomy of the lateral femoral cutaneous nerve.

Sensory distribution of the lateral femoral cutaneous nerve.

Frequency

United States

In the general population, an incidence of 4.3 per 10,000 person years has been reported.

In people with diabetes mellitus, an incidence of 247 per 100,000 patient years has been reported.^[3]

Race

No racial predilection is known.

Sex

No gender proclivity is known.

Age

Lateral femoral cutaneous neuropathies are most common during middle age. However, they have been reported in all age groups.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Elizabeth A Sekul MD, Associate Professor of Pediatrics and Neurology, Medical College of Georgia

Elizabeth A Sekul is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and Child Neurology Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Aashit K Shah, MD Professor of Neurology, Director, Comprehensive Epilepsy Program, Program Director, Clinical Neurophysiology Fellowship, Detroit Medical Center, Wayne State University School of Medicine

Aashit K Shah, MD is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, and American Neurological Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Neil A Busis, MD Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside

Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Chief Editor

Nicholas Lorenzo, MD Consulting Staff, Neurology Specialists and Consultants

Nicholas Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, and American College of Physician Executives

Disclosure: Nothing to disclose.

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