Meralgia Paresthetica Normal Anatomy PowerPoint Presentation

Meralgia  Paresthetica Normal Anatomy PowerPoint Presentation

2018-09-19 7K 7 0 0

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The lateral femoral cutaneous nerve arises from the femoral nerve. Has a cutaneous branch only and supplies the upper and lateral part of the thigh. It emerges from the lateral border of psoas major and moves towards the anterior . ID: 671613

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Presentations text content in Meralgia Paresthetica Normal Anatomy

Slide1

Meralgia Paresthetica

Slide2

Normal Anatomy

The lateral femoral cutaneous nerve arises from the femoral nerve

Has a cutaneous branch only and supplies the upper and lateral part of the thigh

It emerges from the lateral border of psoas major and moves towards the anterior superioriliac spine, under the inguinal ligament and into the thighVariations in normal anatomy and nerve route exist

Slide3

Pathology

Entrapment or dysfunction of the lateral femoral cutaneous nerve causing localized paraesthesia and numbness on the anterolateral aspect of the thigh

Slide4

Mechanism of Injury

Insidious

Obesity

PregnancyWearing belts, corsets or tight trousersLeg length discrepancyLead poisoningAlcoholismDiabetes mellitus

Iatrogenic (caused by medical examination or treatment)

Surgery

Pelvic osteotomy

Spinal surgery

Obtaining Iliac crest bone grafts

Laparoscopic cholecystectomy

Laparoscopic myomectomy

Laparoscopic inguinal hernia

Slide5

Subjective Examination

Paraesthesia in the upper and lateral thigh

Unilateral symptoms

Burning, stinging sensation of the skinAggravated by pressure over inguinal ligamentAggravated by positions of hip extensionEased by sitting down

Slide6

Objective Examination

Tenderness

over the lateral inguinal ligament

Hair loss over anterior thigh due to patient rubbing the areaReduced sensation upper and lateral thighMay have allodynia over the upper and lateral thigh

Slide7

Further Investigation

Nerve conduction study

Slide8

Management

Conservative management usually attempted with a good chance of success in 4 – 6 months

Usually involves treating the underlying cause such as weight loss, wearing tight clothes, belts

etcPhysiotherapy not usually considered but can be used in some cases

Slide9

Conservative

Local anaesthetic block

Slide10

Plan B

Neurolysis

of constricting tissue

Neurolysis and transposition of the lateral femoral cutaneous nerve

Slide11

References

Cheatham, S. W., M. J.

Kolber

and P. A. Salamh (2013). "Meralgia paresthetica: a review of the literature." Int J Sports Phys

Ther

8

(6): 883-893.

Harney, D. and J.

Patijn

(2007). "Meralgia

paresthetica

: diagnosis and management strategies."

Pain Med

8

(8): 669-677.

Patijn

, J., N.

Mekhail

, S. Hayek, A.

Lataster

, M. van

Kleef

and J. Van Zundert (2011). "20. Meralgia

Paresthetica

."

Pain Practice

11

(3): 302-308.


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