History

See the list below:

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.

Physical

See the list below:

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.^[4]
Motor strength in the involved leg should be normal.

Causes

See the list below:

Pregnancy, tight clothing, and obesity predispose to compression of the nerve at the inguinal ligament.^{[5, 6, 7, 3]}Tool belts worn by carpenters, duty belts worn by policemen, and body armor worn by soldiers may compress the LFCN.^[8]
Lying in the fetal position for prolonged periods also has been implicated, as has prone positioning after lumbar spinal surgery.^[9]
Meralgia paresthetica is more common in diabetics than in the general population.^[3]
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.

Differential Diagnoses

Patijn J, Mekhail N, Hayek S, Lataster A, van Kleef M, Van Zundert J. Meralgia Paresthetica. Pain Pract. 2011 May-Jun. 11(3):302-8. [QxMD MEDLINE Link].
Carai A, Fenu G, Sechi E, Crotti FM, Montella A. Anatomical variability of the lateral femoral cutaneous nerve: findings from a surgical series. Clin Anat. 2009 Apr. 22(3):365-70. [QxMD MEDLINE Link].
Parisi TJ, Mandrekar J, Dyck PJ, Klein CJ. Meralgia paresthetica: relation to obesity, advanced age, and diabetes mellitus. Neurology. 2011 Oct 18. 77(16):1538-42. [QxMD MEDLINE Link]. [Full Text].
Nouraei SA, Anand B, Spink G, O'Neill KS. A novel approach to the diagnosis and management of meralgia paresthetica. Neurosurgery. 2007 Apr. 60(4):696-700; discussion 700. [QxMD MEDLINE Link].
Mondelli M, Rossi S, Romano C. Body mass index in meralgia paresthetica: a case-control study. Acta Neurol Scand. 2007 Aug. 116(2):118-23. [QxMD MEDLINE Link].
Chlebowski S, Bashyal S, Schwartz TL. Meralgia paresthetica: another complication of antipsychotic-induced weight gain. Obes Rev. 2009 Apr 1. [QxMD MEDLINE Link].
Moucharafieh R, Wehbe J, Maalouf G. Meralgia paresthetica: a result of tight new trendy low cut trousers ('taille basse'). Int J Surg. 2008 Apr. 6(2):164-8. [QxMD MEDLINE Link].
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. 2007 Jun. 172(6):663-5. [QxMD MEDLINE Link].
Cho KT, Lee HJ. Prone position-related meralgia paresthetica after lumbar spinal surgery : a case report and review of the literature. J Korean Neurosurg Soc. 2008 Dec. 44(6):392-5. [QxMD MEDLINE Link]. [Full Text].
Cheatham SW, Kolber MJ, Salamh PA. Meralgia paresthetica: a review of the literature. Int J Sports Phys Ther. 2013 Dec. 8 (6):883-93. [QxMD MEDLINE Link].
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. Cctober 2007. 77 (3):1362-4. [QxMD MEDLINE Link].
Tumber PS, Bhatia A, Chan VW. Ultrasound-guided lateral femoral cutaneous nerve block for meralgia paresthetica. Anesth Analg. 2008 Mar. 106(3):1021-2. [QxMD MEDLINE Link].
Fowler IM, Tucker AA, Mendez RJ. Treatment of Meralgia Paresthetica with Ultrasound-Guided Pulsed Radiofrequency Ablation of the Lateral Femoral Cutaneous Nerve. Pain Pract. 2011 Dec 7. [QxMD MEDLINE Link].
Tagliafico A, Serafini G, Lacelli F, Perrone N, Valsania V, Martinoli C. Ultrasound-guided treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy): technical description and results of treatment in 20 consecutive patients. J Ultrasound Med. 2011 Oct. 30(10):1341-6. [QxMD MEDLINE Link].
Payne R, Seaman S, Sieg E, Langan S, Harbaugh K, Rizk E. Evaluating the evidence: is neurolysis or neurectomy a better treatment for meralgia paresthetica?. Acta Neurochir (Wien). 2017 May. 159 (5):931-936. [QxMD MEDLINE Link].
Grossman MG, Ducey SA, Nadler SS. Meralgia Paresthetica: diagnosis and treatment. Journal of the American Academy of Orthopaedic Sugeons. 2001. 9:336-44. [QxMD MEDLINE Link].
Harney D, Patijn J. Meralgia paresthetica: diagnosis and management strategies. Pain Med. 2007 Nov-Dec. 8(8):669-77. [QxMD MEDLINE Link].
Jablecki CK. Postoperative lateral femoral cutaneous neuropathy. Muscle Nerve. 1999 Aug. 22(8):1129-31. [QxMD MEDLINE Link].
Seror P, Seror R. Meralgia paresthetica: clinical and electrophysiological diagnosis in 120 cases. Muscle Nerve. 2006 May. 33(5):650-4. [QxMD MEDLINE Link].
Turner OA, Taslitz N, Ward S. Lateral femoral cutaneous nerve of the thigh (meralgia paresthetica). Handbook of peripheral nerve entrapments. 1990. 143-150.
van Slobbe AM, Bohnen AM, Bernsen RM, et al. Incidence rates and determinants in meralgia paresthetica in general practice. J Neurol. 2004 Mar. 251(3):294-7. [QxMD MEDLINE Link].
Williams FH, Johns JS, Weiss JM, et al. Neuromuscular rehabilitation and electrodiagnosis. 1. Mononeuropathy. Arch Phys Med Rehabil. 2005 Mar. 86(3 Suppl 1):S3-10. [QxMD MEDLINE Link].

Media Gallery

Anatomy of the lateral femoral cutaneous nerve.
Sensory distribution of the lateral femoral cutaneous nerve.

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Author

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

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

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Neil A Busis, MD Chief of Neurology and Director of Neurodiagnostic Laboratory, UPMC Shadyside; Clinical Professor of Neurology and Director of Community Neurology, Department of Neurology, University of Pittsburgh Physicians

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

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: American Academy of Neurology<br/>Serve(d) as a speaker or a member of a speakers bureau for: American Academy of Neurology<br/>Received income in an amount equal to or greater than $250 from: American Academy of Neurology.

Chief Editor

Nicholas Lorenzo, MD, CPE, MHCM, FAAPL Co-Founder and Former Chief Publishing Officer, eMedicine and eMedicine Health, Founding Editor-in-Chief, eMedicine Neurology; Founder and Former Chairman and CEO, Pearlsreview; Founder and CEO/CMO, PHLT Consultants; Former Chief Medical Officer, MeMD Inc

Nicholas Lorenzo, MD, CPE, MHCM, FAAPL is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Association for Physician Leadership

Disclosure: Nothing to disclose.

Additional Contributors

Aashit K Shah, MD, FAAN, FANA Chief of Neurology, Carilion Clinic; Professor, Neurology, Virginia Tech Carilion School of Medicine

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

Disclosure: Received research grant from: Eisai; Xenon<br/>Received income in an amount equal to or greater than $250 from: Neurelis Pharma.

Sections Meralgia Paresthetica
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Meralgia Paresthetica Clinical Presentation

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