Meralgia Paresthetica Caused by Surgery in the Park-Bench Position

Area of Science:

• Neurology
• Neurosurgery

Background:

• Meralgia paresthetica (MP) is an entrapment neuropathy affecting the lateral femoral cutaneous nerve (LFCN).
• Microvascular decompression (MVD) is a surgical procedure used to treat neurological conditions like hemifacial spasm.

Observation:

• A 46-year-old woman developed right anterolateral thigh pain and dysesthesia after undergoing two MVD procedures for hemifacial spasm, particularly after the second surgery in the park-bench position.
• Symptoms were localized to the LFCN distribution, and a positive pelvic compression test suggested MP.
• Conservative treatments were ineffective, prompting an LFCN block.

Findings:

• The LFCN block provided significant pain relief, confirming the diagnosis of MP.
• MP is identified as a rare complication associated with MVD surgery performed in the park-bench position.
• The patient experienced symptom resolution with persistent mild dysesthesia after 30 months of follow-up.

Implications:

• This case highlights MP as a potential, albeit rare, complication of MVD surgery in the park-bench position.
• Lateral femoral cutaneous nerve (LFCN) block is a valuable diagnostic and therapeutic tool for managing MP in this context.
• Awareness of this complication is crucial for neurosurgeons performing MVD procedures.