eMedicine Specialties > Orthopedic Surgery > Hip

Meralgia Paresthetica: Follow-up

Author: Ira Kornbluth, MD, MA, Managing Partner, Spine Medicine and Rehabilitation Therapies
Coauthor(s): Phillip J Marone, MD, MSPH, Clinical Professor, Department of Orthopedic Surgery, Jefferson Medical College
Contributor Information and Disclosures

Updated: Mar 16, 2009

Outcome and Prognosis

The outcome of meralgia paresthetica depends largely on whether the diagnosis and treatment plan are achieved within a reasonable time frame. The prognosis from conservative management alone is quite good because the condition often is self-limited. In 277 patients treated conservatively by Williams and Trzil, 91% had satisfactory symptom relief.16 In the worst-case scenario, patients treated conservatively had persistent symptoms such as pain, numbness, burning, hyposensitivity, and tingling in the anterolateral thigh.

Controversial issues include the efficacy of surgery and the selection of a surgical procedure. van Eerten et al17 noted complete symptom relief in 3 of 10 patients who underwent neurolysis and in 9 of 11 patients who had a transection. Similarly, 23 of 24 patients who had a transection in Williams and Trzil's series had complete relief of their presenting symptoms. Ivins reported results for 8 patients who underwent neurolysis; 4 experienced relief of symptoms, of which 2 had recurrence of their symptoms.18 Siu and Chandran reported results from a case series of 45 decompressive procedures in 42 patients who underwent neurolysis: 43% reported complete relief, 40% reported partial relief, and 17% reported no relief.19

Although transection is more likely to produce complete relief, it likely will cause permanent anesthesia of the anterolateral thigh.

Future and Controversies

As physicians and patients become increasingly aware of meralgia paresthetica and as new medications and surgical techniques develop, the diagnosis and initiation of a treatment plan will be made more rapidly. Patients and physicians alike would benefit from an algorithm guiding diagnosis and treatment.

 


More on Meralgia Paresthetica

Overview: Meralgia Paresthetica
Workup: Meralgia Paresthetica
Treatment: Meralgia Paresthetica
Follow-up: Meralgia Paresthetica
Multimedia: Meralgia Paresthetica
References
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References

  1. Craig E. Lateral femoral cutaneous neuropathy. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. Boston, Mass: Hanley & Belfus; 2001:. 279-82.

  2. Preston DC, Shapiro BE. Lateral femoral cutaneous neuropathy. In: Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations. Boston, Mass: Butterworth-Heinemann; 1997:. 477.

  3. Seror P, Seror R. Meralgia paresthetica: clinical and electrophysiological diagnosis in 120 cases. Muscle Nerve. May 2006;33(5):650-4. [Medline].

  4. Mondelli M, Rossi S, Romano C. Body mass index in meralgia paresthetica: a case-control study. Acta Neurol Scand. Aug 2007;116(2):118-23. [Medline].

  5. Fargo MV, Konitzer LN. Meralgia paresthetica due to body armor wear in U.S. soldiers serving in Iraq: a case report and review of the literature. Mil Med. Jun 2007;172(6):663-5. [Medline].

  6. Moucharafieh R, Wehbe J, Maalouf G. Meralgia paresthetica: a result of tight new trendy low cut trousers ('taille basse'). Int J Surg. Apr 2008;6(2):164-8. [Medline].

  7. Sunderland S. Anatomical features of nerve trunks in relation to nerve injury and nerve repair. Clin Neurosurg. 1970;17:38-62. [Medline].

  8. de Ridder VA, de Lange S, Popta JV. Anatomical variations of the lateral femoral cutaneous nerve and the consequences for surgery. J Orthop Trauma. Mar-Apr 1999;13(3):207-11. [Medline].

  9. Schestatsky P, Lladó-Carbó E, Casanova-Molla J, Alvarez-Blanco S, Valls-Solé J. Small fibre function in patients with meralgia paresthetica. Pain. Oct 15 2008;139(2):342-8. [Medline].

  10. Grossman MG, Ducey SA, Nadler SS, Levy AS. Meralgia paresthetica: diagnosis and treatment. J Am Acad Orthop Surg. Sep-Oct 2001;9(5):336-44. [Medline].

  11. Nahabedian MY, Dellon AL. Meralgia paresthetica: etiology, diagnosis, and outcome of surgical decompression. Ann Plast Surg. Dec 1995;35(6):590-4. [Medline].

  12. Shimizu S. A novel approach to the diagnosis and management of meralgia paresthetica. Neurosurgery. Oct 2008;63(4):E820. [Medline].

  13. Tumber PS, Bhatia A, Chan VW. Ultrasound-guided lateral femoral cutaneous nerve block for meralgia paresthetica. Anesth Analg. Mar 2008;106(3):1021-2. [Medline].

  14. Hurdle MF, Weingarten TN, Crisostomo RA, Psimos C, Smith J. Ultrasound-guided blockade of the lateral femoral cutaneous nerve: technical description and review of 10 cases. Arch Phys Med Rehabil. Oct 2007;88(10):1362-4. [Medline].

  15. Alberti O, Wickboldt J, Becker R. Suprainguinal retroperitoneal approach for the successful surgical treatment of meralgia paresthetica. J Neurosurg. Oct 31 2008;[Medline].

  16. Williams PH, Trzil KP. Management of meralgia paresthetica. J Neurosurg. Jan 1991;74(1):76-80. [Medline].

  17. van Eerten PV, Polder TW, Broere CA. Operative treatment of meralgia paresthetica: transection versus neurolysis. Neurosurgery. Jul 1995;37(1):63-5. [Medline].

  18. Ivins GK. Meralgia paresthetica, the elusive diagnosis: clinical experience with 14 adult patients. Ann Surg. Aug 2000;232(2):281-6. [Medline].

  19. Siu TL, Chandran KN. Neurolysis for meralgia paresthetica: an operative series of 45 cases. Surg Neurol. Jan 2005;63(1):19-23; discussion 23. [Medline].

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Further Reading

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Keywords

meralgia paresthetica, lateral femoral cutaneous nerve neuropathy, neuropraxic injury, axonotmesis, neurotmesis, thigh pain, lateral femoral cutaneous nerve compression, leg neuropathy, thigh neuropathy, nerve entrapment syndromes, nerve entrapment of the lower extremity

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Contributor Information and Disclosures

Author

Ira Kornbluth, MD, MA, Managing Partner, Spine Medicine and Rehabilitation Therapies
Ira Kornbluth, MD, MA is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Society of Interventional Pain Physicians, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Coauthor(s)

Phillip J Marone, MD, MSPH, Clinical Professor, Department of Orthopedic Surgery, Jefferson Medical College
Phillip J Marone, MD, MSPH is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Medical Association, American Orthopaedic Society for Sports Medicine, and Philadelphia County Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Miguel A Schmitz, MD, Consulting Surgeon, Department of Orthopedics, Klamath Orthopedic and Sports Medicine Clinic
Miguel A Schmitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

B Sonny Bal, MD, Associate Professor, Department of Orthopedic Surgery, University of Missouri School of Medicine
B Sonny Bal, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

William L Jaffe, MD, Clinical Professor of Orthopedic Surgery, New York University School of Medicine; Vice Chairman, Department of Orthopedic Surgery, New York University Hospital for Joint Diseases
William L Jaffe, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Orthopaedic Association, Eastern Orthopaedic Association, and New York Academy of Medicine
Disclosure: Stryker Orthopaedics Consulting fee Speaking and teaching

 
 
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