Surgery for Meralgia Paresthetica Workup

  • Author: Ira Kornbluth, MD, MA; Chief Editor: William L Jaffe, MD   more...
 
Updated: Jun 29, 2011
 

Laboratory Studies

  • Laboratory evaluation for diabetes and thyroid disorders may be warranted in some cases. Although meralgia paresthetica is not an obscure condition, the diagnosis may be elusive because it is based largely on clinical grounds.
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Imaging Studies

  • Imaging studies are not of any specific benefit in diagnosing meralgia paresthetica, except in excluding differential diagnoses.
  • If a mass lesion or fracture is suspected as the cause of this entity, appropriate imaging may be warranted.
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Other Tests

An electrodiagnostic evaluation, including electromyography (EMG) and nerve conduction studies, is often not necessary but may be helpful as an adjunct to the history and physical examination in confirming the diagnosis of meralgia paresthetica and establishing a prognosis. Nerve conduction tests can help determine the severity of the nerve injury by comparing the result with standard values and with the contralateral side. The smaller the amplitude relative to the contralateral side, the greater the nerve dysfunction. Frequently, recording needles are required for sensory testing to ensure adequate responses. If very low amplitudes are obtained, an average of responses may be used. Needle EMG testing should be performed to evaluate for other conditions such as radiculopathy or other peripheral neuropathies.

Comparing nerve conduction study findings on the affected side with those from the contralateral side provides some indication of the nature and severity of the nerve injury. Studies may be confounded by the fact that many patients have bilateral involvement. The lateral femoral cutaneous nerve can be stimulated as it exits the pelvis, with potentials recorded distally, or it can be stimulated distally, with recordings made proximally.

Needle EMG may be performed to exclude other pathology. In meralgia paresthetica, needle EMG findings should be normal.

Somatosensory evoked potentials have been found to be less accurate than nerve conduction studies.

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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.

Specialty Editor Board

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, Arthroscopy Association of North America, and North American Spine Society

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

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.

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

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

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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The lateral femoral cutaneous nerve provides sensory innervation to the anterolateral thigh. Courtesy of Essentials of Physical Medicine and Rehabilitation, Hanley & Belfus Publishers, 2001, used with permission.
 
 
 
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