Management of meralgia paresthetica

Meralgia paresthetica is a syndrome of pain or dysesthesia, or both, in the anterolateral thigh caused by entrapment or neurinoma formation of the lateral femoral cutaneous nerve. Conservative treatment was successful in relieving symptoms in 91% of 277 patients with this syndrome; however, 24 patients required surgical treatment for intractable symptoms. Although neurolysis with transposition is the most common procedure, sectioning of the lateral femoral cutaneous nerve was performed in 24 cases and was successful in 23. One patient had early symptomatic relief, but subsequently developed different neurological signs and symptoms because of an undetected pelvic neoplasm. Anatomical variations of the nerve and neurinomas, which occur frequently, are easily handled with sectioning but may lead to recurrence with neurolysis and transposition.