Meralgia Paresthetica

Fakultas Kedokteran Universitas Sumatera Utara

PPDS Neurologi
Modul Saraf Tepi
Pembimbing : Dr.dr. Aida Fithrie,
Sp.S(K)
PPDS : dr. Alvin
Hadisaputra
Introduction
 Meralgia Paresthetica (MP) is a common condition
 Often misdiagnosed because mimicking other conditions
 Impingement of the lateral femoral cutaneous nerve
(LFCN)
 Numbness, burning, stabbing, and aching along the well-
delineated path of the LFCN, from the front of the thigh
to just above the knee.
Etiology
 The most common cause of impingement of the LFCN is entrapment of the
nerve under the inguinal ligament.

Mechanical Metabolic

Iatrogenic
Etiology

Mechanical
 Pregnancy
 Increased abdominal pressure
 Obesity
 Wearing tight clothing/belts in the waist area
 Different leg lengths
 Pubic symphysis (pelvic girdle) dysfunction
 Carrying items such as a wallet or a cell phone in the front and side
pockets of pants
Etiology
Metabolic
 Diabetes
 Alcoholism
 Hypothyroidism
 Lead poisoning

Iatrogenic
 Prolonged traction during spine surgery or injury to the nerve during
retroperitoneal dissection
Differential Diagnosis
 Spinal nerve radiculopathy at L1-L3
 Malignancy or metastasis to the iliac crest
 Uterine fibroids or pelvic mass that compress the nerve
 Avulsion fracture of the anterior superior iliac spine
(ASIS)
 Chronic appendicitis
Clinical Evaluation
 History taking
 The pelvic compression test
 Sensory testing
 A diminished or absent cremasteric reflex (in male patients)
 Manual muscle testing of myotomes L2-L5
 The patellar tendon reflex
 Straight Leg Raising (SLR) test
 Motor or sphincter dysfunction
Diagnostic Evaluation
Laboratory

 Thyroid function,
 Vitamin B12 and folate levels,
 Serum lead levels
 Complete blood count may be ordered to evaluate for macrocytic anemia
 Blood glucose level to detect diabetes in patients with neuropathy symptoms
Diagnostic Evaluation
Radiology

 Plain radiographs (x-rays) of the pelvis and hip (AP and frog leg views) should
be obtained first to rule out osteoarthritis of the hip joint or bone
metastasis to the ileum
 Magnetic resonance imaging or computed tomography can rule out disc
herniation, nerve lesions, annular tears, or other spinal pathology that may
be causing radiculopathy
 A pelvic ultrasound should be obtained in women of childbearing age with a
history of prolonged menstrual bleeding to rule out uterine fibroids
Treatment
 Removing any underlying cause of the impingement
 Oral anti-inflammatory (NSAIDs or steroids)
 85% of patients will have improved symptoms with conservative treatment alone
 Physical therapy
 Injection
 Surgery
Thank You
PPDS Neurologi Universitas Sumatera Utara. MMXX