共查询到10条相似文献，搜索用时 62 毫秒
1.
2.
Recognizing the cause is essential for the management of meralgia paresthetica (MP), also known as lateral femoral cutaneous neuropathy. The aim of this study was to investigate the etiologies of MP and their influence on each other. This retrospective study enrolled referral patients with electromyographic studies who fulfilled the clinical and electrodiagnostic criteria of MP from January 2003 to December 2013. Data including age, gender, body weight, body height, occupation, and relevant medical history were collected. The etiological analysis was based on age and gender. A total of 50 patients (30 males and 20 females) were enrolled. The average age (±standard deviation) at diagnosis was 49.8 ± 12.8 years. Risk factors were identified in 29 cases (58.0%). More patients younger than 50 years of age were male (73.1%, p = 0.049). Peaks of age occurred between 41–50 years in men and 51–60 years in women. More males had a body mass index ≥ 24 kg/m2 (69.2% vs. 31.6%, p = 0.012) and ≥27 kg/m2 (34.6% vs. 0.0%, p = 0.006). Overweight and obese patients were more vulnerable to occupational factors (50.0% vs. 19.0%, p = 0.030). Only one case had diabetes mellitus (2%). Male middle-aged patients with a higher body mass index and certain occupations had an increased risk of MP. In contrast to the peak age distribution of the male patients, the frequency of developing MP was relatively even among the women at all ages. The cause was often obscure. 相似文献
3.
Introduction: Meralgia paresthetica is a common clinical complaint for which some patients ultimately undergo surgical treatment. The lateral femoral cutaneous nerve (LFCN) has been difficult to reliably test electrophysiologically, likely due to anatomic variability and lack of responses in asymptomatic obese subjects. Methods: We compared a novel ultrasound‐guided antidromic sensory nerve conduction study (NCS) with a technique described previously in a population of normal subjects, of whom 50% had body mass indices within the obese range (>27.5). Results: Responses were obtained in at least 92% of subjects using either technique, and 92% of normal subjects had <60% interside variability using the ultrasound‐guided technique. Conclusions: LFCN sensory nerve action potentials can be obtained in the vast majority of normal subjects, even in an obese population and can provide a useful sensory NCS for evaluation of mid‐lumbar radiculopathy, plexopathy, or meralgia paresthetica. Muscle Nerve, 2011 相似文献
4.
We report three patients with a typical clinical picture of unilateral meralgia paresthetica in whom routine nerve conduction studies were normal. However, cortical somatosensory evoked potentials were absent after lateral femoral cutaneous nerve (LFCN) stimulation on the affected side. After stimulation of the LFCN in the anterosuperior iliac spine (ASIS) region and recording the responses distal to conventional sites (20 cm from the ASIS), sensory nerve action potentials (SNAPs) were absent in the symptomatic leg, but present in the normal leg. We suggest that thigh paresthesias may be caused by a distal LFCN lesion. Eliciting this requires recording SNAPs distal to conventional sites. 相似文献
5.
We report the results of clinical and electrophysiological examinations in 131 cases of meralgia paresthetica (MP) among 120 unselected patients, 69 men and 51 women, aged 15-81 years. All patients experienced permanent or intermittent pain, and all but one had permanent sensory impairment of the thigh. The lateral aspect of the thigh was solely involved in 88 cases and the anterior aspect was also or exclusively involved in 32 cases. The right thigh was involved 62 times and the left 58 times. Symptom duration varied from 2 weeks to 20 years. The initial diagnosis was meralgia paresthetica in 47 cases (39%), root disease in 35 cases, and osteoarthritis in 6 cases; no diagnosis was proposed in the 32 remaining cases. Two cases had undergone previous spine surgery for disk herniation, with no benefit. A precise cause could explain the lateral femoral cutaneous nerve (LFCN) lesion in 46 cases, the other 74 cases being considered idiopathic (25% of patients were obese). Only one case required surgery to relieve symptoms. LFCN conduction was studied orthodromically, distally from the anterior superior iliac spine. The side-to-side amplitude ratio (ssRatio) was greater than 2.3 in 118 of 120 patients (98.3%) and was a better index to confirm a lesion of the LFCN than SNAP amplitude, which was abnormal (less than 3 microV) in 88 cases (73.3%). Only two of the 11 bilateral cases had an ssRatio lower than 2.3 (they were both 2.0). An ssRatio of 2.3 or more and a SNAP amplitude lower than 3 microV provided a specificity of 98.75% or more. The mean axonal loss was 88%. These clinical and electrophysiological data highlight the central role the neurophysiologist should play in diagnosing MP by means of an LFCN conduction study. 相似文献
6.
Surgical treatment of lateral femoral cutaneous neuropathy (LFCN) is performed only after failure of conservative management. We reexamined 167 cases (7 bilateral) of LFCN of various etiologies (idiopathic, abdominal surgery, iliac crest bone grafting, trauma, and total hip arthroplasty) operated on between 1987 and 2003. Average follow-up was 98 months (20-212). The intervention was performed under local anesthesia in 139 cases (83%). Surgical release of the nerve was performed in 153 cases (92%) and transection in 14 cases (8%). Surgical treatment of LFCN led to improvement and patient satisfaction in 130 cases (78%). The results depended on several factors, especially the underlying etiology, duration of symptoms before intervention, and integrity of the nerve. Nerve release remains the first-line surgical technique, improving painful symptoms in many cases while preserving sensation of the thigh. It can be performed under local anesthesia by an experienced surgeon. 相似文献
7.
We present three patients with signs and symptoms of meralgia paresthetica (MP) after long-distance walking and cycling. No other possible causes of MP, such as trauma or exogenous compression, were present. A neuropathy of the lateral femoral cutaneous nerve was confirmed in all patients with somatosensory evoked potentials. We propose that conduction block due to local ischemia during repetitive muscle stretching was the probable cause for the neuropathy. 相似文献
8.
Introduction: Meralgia paresthetica can be difficult to diagnose, as neurophysiological studies are often hard to interpret due to excess fatty tissue and the varying anatomy of the lateral femoral cutaneous nerve. Methods: We retrospectively analyzed the use of high‐resolution ultrasound (HRU) for confirming clinical meralgia paresthetica and compared results with nerve conduction studies. Results: In all 6 patients evaluated, HRUs showed significantly enlarged nerve diameter and in 3 enlarged cross‐sectional area, 4 had absent nerve potentials, and in 2 the potentials could not be recorded on either side. Conclusions: HRU seems promising for confirming meralgia paresthetica and can accurately localize nerve entrapment. Muscle Nerve, 2012 相似文献
9.
BC Son DR Kim IS Kim JT Hong JH Sung SW Lee 《Journal of Korean Neurosurgical Society》2012,51(6):363-366
Objective
Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue.Methods
During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted.Results
Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported.Conclusion
Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP. 相似文献10.
Cordato DJ Yiannikas C Stroud J Halpern JP Schwartz RS Akbunar M Cook M 《Muscle & nerve》2004,29(1):139-142
Seventy-five consecutive patients with clinical symptoms and signs of meralgia paresthetica underwent bilateral somatosensory evoked potential (SEP) studies involving stimulation of skin areas innervated by the lateral and anterior femoral cutaneous nerves of the thighs. The most common abnormality was an absolute lateral femoral cutaneous SEP latency > 40 ms in 35 patients (47%), followed by an absent response in 14 patients (19%), an absolute latency < 40 ms but amplitude reduction > 50% compared with the contralateral response in 8 patients (11%), and an absolute latency < 40 ms but > 5 ms interside latency difference in 5 patients (7%). Anterior femoral cutaneous SEPs were of value in distinguishing meralgia paresthetica from a proximal lumbar radiculopathy in an additional 4 patients and confirming bilateral meralgia paresthetica in 10 patients. 相似文献
