Meralgia Paresthetica after Prone Positioning Ventilation in the Intensive Care Unit

Area of Science:

• Neurology
• Intensive Care Medicine
• Pulmonology

Background:

• Meralgia paresthetica (MP) is a mononeuropathy affecting the lateral femoral cutaneous nerve (LFCN) due to external compression.
• Acute respiratory distress necessitates intensive care unit (ICU) admission and mechanical ventilation, often involving prone positioning.

Purpose of the Study:

• To report a novel case of bilateral meralgia paresthetica following mechanical ventilation in the prone position.
• To describe the clinical presentation and diagnostic findings of this potential ICU-related complication.

Main Methods:

• A case report detailing a patient with Legionella pneumonia requiring mechanical ventilation.
• Neurological and neurophysiological examinations were performed six months post-ICU stay.
• Review of the patient's ICU course, focusing on the duration and specifics of prone position ventilation.

Main Results:

• The patient developed persistent bilateral numbness in the anterolateral thigh after mechanical ventilation.
• Neurological examination and neurophysiological testing confirmed bilateral meralgia paresthetica.
• This represents the first reported instance of MP as a complication of prone position mechanical ventilation.

Conclusions:

• Mechanical ventilation in the prone position may be an iatrogenic cause of meralgia paresthetica.
• Clinicians should consider MP in patients presenting with thigh numbness after prolonged ICU stays involving prone ventilation.
• Further research is warranted to elucidate the mechanism and incidence of this complication.