110 - Meralgia Paresthetica

Abstract

Meralgia paresthetica is caused by compression of the lateral femoral cutaneous nerve by the inguinal ligament. This entrapment neuropathy manifests as pain, numbness, and dysesthesias in the distribution of the lateral femoral cutaneous nerve. The symptoms often begin as a burning pain in the lateral thigh, with associated cutaneous sensitivity. Patients suffering from meralgia paresthetica note that sitting, squatting, or wearing low-cut trousers (taille basse) and wide belts causes the symptoms to worsen. Although traumatic lesions to the lateral femoral cutaneous nerve have been implicated in meralgia paresthetica, in most patients, no obvious antecedent trauma can be identified. Physical findings include tenderness over the lateral femoral cutaneous nerve at the origin of the inguinal ligament at the anterior superior iliac spine. A positive Tinel sign over the lateral femoral cutaneous nerve as it passes beneath the inguinal ligament may be present. Patients may complain of burning dysesthesias in the nerve distribution. Careful sensory examination of the lateral thigh reveals a sensory deficit in the distribution of the lateral femoral cutaneous nerve; no motor deficit should be present. Sitting or wearing low-cut trousers (taille basse), tight waistbands, or wide belts can compress the nerve and exacerbate the symptoms of meralgia paresthetica.