scholarly journals A cook with ‘burning in the thigh’ and a ‘hotspot’ in the groin!

2021 ◽  
Vol 2021 (11) ◽  
Author(s):  
Wai Lun Moy
Keyword(s):  
Physical Examination ◽  
General Medicine ◽  
Burning Sensation ◽  
Resonance Imaging ◽  
Advanced Imaging ◽  
Meralgia Paresthetica ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve ◽  
General Medicine Clinic ◽  
The Right

ABSTRACT Meralgia paresthetica (MP) is a condition characterised by abnormal sensations on the anterolateral aspect of the thigh due to the dysfunction of the lateral femoral cutaneous nerve. Here, I present a case of a 64-year-old female cook who attended the General Medicine clinic with 2 months of persistent numbness and ‘burning’ sensation over the right anterolateral thigh. Subsequent physical examination revealed the diagnosis of meralgia paresthetica. The significance of good history taking and thorough physical examination in reaching the diagnosis of meralgia paresthetica cannot be overemphasized. In most typical presentations, advanced imaging and neurodiagnostic testing do not add value to confirm the diagnosis. If the clinical diagnosis is doubtful, nerve conduction study and magnetic resonance imaging may still be performed to exclude other mimicking pathologies. Increasing awareness of MP among doctors unfamiliar with this condition will prevent the ordering of excessive investigations.

scholarly journals Effects of oxygen-ozone therapy in the Roth syndrome: a case report

Ozone Therapy ◽  
2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Alfredo Romeo ◽  
Carolina Baiano ◽  
Marianna Chierchia ◽  
Francesco Scandone
Keyword(s):  
Case Report ◽  
Intractable Pain ◽  
Low Back ◽  
Ozone Therapy ◽  
Meralgia Paresthetica ◽  
Burning Pain ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve ◽  
History Of ◽  
The Right

Meralgia paresthetica (MP) is a disesthetic and/or anesthetic syndrome in the distribution of the lateral femoral cutaneous nerve. It is a compressive or traumatic mononeuropathy, characterized by burning pain and/or discomfort in the anterolateral thigh, without motor or muscle strength changes, with preserved reflexes. The authors report the case of a 52-year-old male with a history of low back pain presented from two-year sensory dysesthesias and paresthesias in the right anterolateral thigh, consistent with meralgia paresthetica; they also describe the first reported use of O2-O3 therapy to relieve the intractable pain associated with MP.

The lateral femoral cutaneous nerve canal

2017 ◽  
Vol 126 (3) ◽  
pp. 972-978 ◽  
Author(s):  
Amgad Hanna
Keyword(s):  
Iliac Crest ◽  
Intraoperative Imaging ◽  
Femoral Nerve ◽  
Anatomical Variations ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Nerve Transection ◽  
Meralgia Paresthetica ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve

OBJECTIVE Meralgia paresthetica causes dysesthesias and burning in the anterolateral thigh. Surgical treatment includes nerve transection or decompression. Finding the nerve in surgery is very challenging. The author conducted a cadaveric study to better understand the variations in the anatomy of the lateral femoral cutaneous nerve (LFCN). METHODS Twenty embalmed cadavers were used for this study. The author studied the LFCN's relationship to different fascial planes, and the distance from the anterior superior iliac spine (ASIS). RESULTS A complete fascial canal was found to surround the nerve completely in all specimens. The canal starts at the inguinal ligament proximally and follows the nerve beyond its terminal branches. The nerve could be anywhere from 6.5 cm medial to the ASIS to 6 cm lateral to the ASIS. In the latter case, the nerve may lodge in a groove in the iliac crest. Other anatomical variations found were the LFCN arising from the femoral nerve, and a duplicated nerve. A thick nerve was found in 1 case in which it was riding over the ASIS. CONCLUSIONS The variability in the course of the LFCN can create difficulty in surgical exposure. The newly defined LFCN canal renders exposure even more challenging. This calls for high-resolution pre- or intraoperative imaging for better localization of the nerve.

Lateral Femoral Cutaneous Neuropathy—Meralgia Paresthetica

2018 ◽  
Author(s):  
Srinivas Chiravuri
Keyword(s):  
Treatment Modalities ◽  
Invasive Treatment ◽  
External Compression ◽  
Meralgia Paresthetica ◽  
Initial Management ◽  
Nerve Structure ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve ◽  
Dorsal Rami ◽  
Direct Nerve

Meralgia paresthetica is characterized by anterolateral thigh pain, paresthesia, or dysesthesia without motor weakness. This is due to idiopathic or iatrogenic injury to the lateral femoral cutaneous nerve (LFCN, dorsal rami of L2-L3). Risk factors include obesity, diabetes, and external compression near the inguinal ligament’s attachment to the anterior superior iliac spine. Diagnosis is based on clinical presentation and electrodiagnostic studies. Initial management includes behavioral modification, physical therapy, and pharmacotherapy. More invasive treatment modalities include LFCN infiltration, pulsed radiofrequency, direct nerve stimulation, and spinal cord stimulation. Ultrasound-guided neurectomy is also an effective way to localize the nerve structure and ensure complete nerve transection.

scholarly journals Meralgia Paresthetica after Prone Positioning Ventilation in the Intensive Care Unit

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Christian Svendsen Juhl ◽  
Martin Ballegaard ◽  
Morten H. Bestle ◽  
Peer Tfelt-Hansen
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Prone Position ◽  
Prone Positioning ◽  
External Compression ◽  
Meralgia Paresthetica ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve ◽  
Patient Reported

Meralgia paresthetica (MP) is a mononeuropathy of the lateral femoral cutaneous nerve (LFCN) caused by external compression of the nerve during its course close to the anterior superior iliac spine. We present a case of a patient with acute respiratory distress induced byLegionellapneumonia who was admitted to the intensive care unit (ICU) for mechanical ventilation. In the ICU, the patient received one session of prone position ventilation for 8.5 consecutive hours. At evaluation six months later, the patient reported persistent bilateral numbness of the anterolateral thigh, which he complained had begun right after he woke up at the ICU. He was referred for further neurological and neurophysiological examination and was diagnosed with bilateral MP, a condition never previously described as a complication to mechanical ventilation in prone position in the ICU.

scholarly journals Meralgia paresthetica – Solving the diagnostic dilemma

2018 ◽  
Vol 9 (3) ◽  
pp. 96
Author(s):  
Bishnu Pokharel ◽  
Rosan Prasad Shah Kalawar ◽  
Guru Prasad Khanal
Keyword(s):  
Wide Spectrum ◽  
Anatomical Variations ◽  
Clinical Syndrome ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Diagnostic Dilemma ◽  
Trochanteric Bursitis ◽  
Meralgia Paresthetica ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve

Meralgia paraesthetica (MP) is a clinical syndrome produced by entrapment mono-neuropathy of lateral femoral cutaneous nerve (LFCN). It classically presents as numbness, paresthesia or dysesthesia of anterolateral aspect of thigh but sometime it may mimic conditions like lumbar radiculopathy, femoro-acetabular impingement, trochanteric bursitis, etc. Since it has wide spectrum of clinical presentation, it should be the diagnosis of exclusion when causes of anterolateral thigh pain is not explained by other known causes. The aim of this review is to provide an overview of this clinical condition with the emphasis on various clinical presentations and anatomical variations of the lateral femoral cutaneous nerve. Different methods of diagnosis and treatment are also explored and discussed in this paper.

Medical and surgical treatment of meralgia paresthetica

2021 ◽  
Author(s):  
Hande Gurbuz ◽  
Alper Gultekin
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Burning Sensation ◽  
Cutaneous Nerve ◽  
Lateral Femoral Cutaneous Nerve ◽  
Meralgia Paresthetica ◽  
Advantages And Disadvantages ◽  
Interventional Management ◽  
Femoral Cutaneous Nerve ◽  
Surgical Treatments

Meralgia paresthetica (MP) is a painful mononeuropathy that causes paresthesia, tingling, stinging or a burning sensation in the thigh’s anterolateral part due to the entrapment of the lateral femoral cutaneous nerve under the inguinal ligament. The treatment options for MP include conservative or interventional management and must follow an algorithm. The objective is to eliminate the underlying cause if known. In the present study, four patients with MP who were successfully treated with either conservative or interventional management are presented. The advantages and disadvantages of neurolysis (decompression and transposition) and neurectomy procedures for surgical treatments are discussed.

scholarly journals PROLONGED PAIN RELIEF WITH USE OF 10% LIDOCAINE NEUROLYSIS FOR REFRACTORY MERALGIA PARESTHETICA

2019 ◽  
pp. 121-125
Author(s):  
Gaurav Chauhan
Keyword(s):  
Neuropathic Pain ◽  
Sensory Neuropathy ◽  
Invasive Procedures ◽  
Meralgia Paresthetica ◽  
Steroid Injections ◽  
Pain Medications ◽  
Novel Approach ◽  
Anterolateral Thigh ◽  
Femoral Cutaneous Nerve ◽  
Prolonged Pain

Meralgia paresthetica is a sensory neuropathy characterized by anterolateral thigh pain associated with paresthesiae. It is hypothesized that entrapment, compression, or stretching of the lateral femoral cutaneous nerve as it exits through the inguinal ligament. Often times life style modification, neuropathic pain medications, and or steroid injections can help relieve the pain. In some circumstances, the pain is refractory and more invasive procedures such as radiofrequency ablation and or even surgery may need to be pursued. The authors report the successful use of 10% lidocaine for chemical neurolysis for Meralgia paresthetica in a 47-year-old female refractory to conventional treatment. In this case report, we will discuss the risk factors, pathomechanics, diagnostic challenges, therapeutic options and novel approach employed by the authors. Key words: 10% lidocaine, chemical neurolysis, meralgia, aresthetica, neuropathic pain

scholarly journals Difference in the general medicine in-training examination score between community-based hospitals and university hospitals: a cross-sectional study based on 15,188 Japanese resident physicians

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Nishizaki ◽  
Keigo Nozawa ◽  
Tomohiro Shinozaki ◽  
Taro Shimizu ◽  
Tomoya Okubo ◽  
...  
Keyword(s):  
Physical Examination ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Medical Interview ◽  
Sectional Study ◽  
University Hospitals ◽  
Community Based ◽  
Cross Sectional ◽  
Clinical Competencies ◽  
Clinical Procedures

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”

scholarly journals Developmentally anomalous cerebellar encephalocele arising within the cerebellopontine angle and extending into the adjacent skull base in a pediatric patient

2021 ◽  
Author(s):  
Forrest A. Hamrick ◽  
Michael Karsy ◽  
Carol S. Bruggers ◽  
Angelica R. Putnam ◽  
Gary L. Hedlund ◽  
...  
Keyword(s):  
Skull Base ◽  
Pediatric Patient ◽  
Cerebellopontine Angle ◽  
Resonance Imaging ◽  
Middle Cerebellar Peduncle ◽  
Cerebellar Tissue ◽  
Cerebellar Peduncle ◽  
Histopathologic Analysis ◽  
The Right ◽  
Internal Acoustic Canal

AbstractLesions of the cerebellopontine angle (CPA) in young children are rare, with the most common being arachnoid cysts and epidermoid inclusion cysts. The authors report a case of an encephalocele containing heterotopic cerebellar tissue arising from the right middle cerebellar peduncle and filling the right internal acoustic canal in a 2-year-old female patient. Her initial presentation included a focal left 6th nerve palsy. Magnetic resonance imaging was suggestive of a high-grade tumor of the right CPA. The lesion was removed via a retrosigmoid approach, and histopathologic analysis revealed heterotopic atrophic cerebellar tissue. This report is the first description of a heterotopic cerebellar encephalocele within the CPA and temporal skull base of a pediatric patient.

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