Sunday, February 9, 2014

MERALGIA PARESTHETICA

MERALGIA PARESTHETICA

Introduction

Meralgia paresthetica is a condition, characterised by sensations of burning, tingling and pain in the upper outer aspect of thigh.

What is the underlying cause of meralgia paresthetica?

It is caused by entrapment or compression of the nerve that supplies sensation to the upper, outer aspect of thigh. The nerve is commonly called as lateral femoral cutaneous nerve of the thigh.

The condition can get aggravated by sitting in one position for a long time, wearing a tight belt, wearing skinny jeans, or compression of nerve by protruding abdomen in an obese person. 

What are the common symptoms of meralgia paresthetica?

The common symptoms include one or more of the following symptoms, affecting the upper/mid thigh region:

  • Numbness,
  • Tingling,
  • Burning, 
  • Pain. 
These symptoms occur more on sitting or standing, and get mildly relieved on lying down down. They may be more severe at night.

The picture (shaded area) below shows the location of symptoms over thigh in meralgia paresthetica.



How is the diagnosis of meralgia paresthetica confirmed?

The diagnosis is made on the basis of clinical symptoms and signs and no tests are often necessary. However, nerve conduction studies of femoral nerve can be done in some cases. In atypical cases, MRI of lumbo-sacral spine may be required to exclude pinching of nerves in the lower back.

How do we treat meralgia paresthetica?

The treatment is with medications such as pregabalin, gabapentin, duloxetine, etc, which are very effective in reducing nerve-related pain, burning and tingling.

In addition, if the person is obese/overweight, then, weight reduction is advised. Prolonged sitting should be avoided.

In 90% of cases, the above treatment would succeed. However, in 10% of cases, symptoms do not improve with medical treatment, and surgery may be required.

The surgical options include decompression of the nerve or division of the nerve. Division of the nerve may leave numbness in the affected region.

What is the outcome of meralgia paresthetica?

Most people do well with treatment and no long-term residual symptoms or disability occurs in patients suffering from this condition.

I hope this article would help patients suffering from this condition, and also enrich the knowledge of readers. I would be pleased to answer any queries related to this condition. My email is drsudhirkumar@yahoo.com 

Dr Sudhir Kumar MD (Internal Medicine) DM (Neurology)
Senior Consultant Neurologist,
Apollo Health City, Hyderabad
Phone: 0091-40-23607777
email: drsudhirkumar@yahoo.com 
Online consultation: http://members.tripod.com/sudhirkumar_5/neurologist/id6.html