Unusual Localized Pre-orgasmic Sensory Phenomenon Following Meralgia Paresthetica Recovery: A Case Report

Meralgia paresthetica (MP) is a relatively uncommon neuropathy caused by compression or injury of the lateral femoral cutaneous nerve (LFCN), which provides sensory innervation to the anterolateral thigh. While sensory symptoms during active MP are well described, long-term alterations in sensation following recovery have rarely been reported. Here, we present the case of a 79-year-old man who developed a highly localized, reproducible, and intensely pleasurable tingling sensation over the external aspect of his left thigh following full resolution of MP. Remarkably, this sensation emerged consistently within two seconds prior to orgasm during sexual activity, without direct genital involvement. The sensation was perceived as emotionally restorative and stronger than the orgasm itself. In some cases, it could also be triggered by light touch to the affected area. Neurological examination was normal, with intact motor function and no signs of radiculopathy. Routine laboratory tests, including complete blood count, blood glucose, inflammatory markers, and urinalysis, were unremarkable. The patient reported no similar prior symptoms and had no relevant neurological or psychiatric history. We propose that the phenomenon may reflect cortical remapping, peripheral nerve regeneration, or somato-autonomic cross-activation. This case highlights the potential for uncommon, yet positive, sensory phenomena following peripheral nerve injury and invites further investigation into their underlying mechanisms.