Meralgia paresthetica: A retrospective analysis of 79 patients evaluated and treated according to a standard algorithm.
BACKGROUND
The efficacy of various treatment modalities in meralgia paresthetica (MP) is not established. We retrospectively evaluated the management of spontaneous MP (i.e. MP not secondary to trauma or surgery) according to a standard algorithm.


METHODS
Initial management included oral medications, rest, and reduction of aggravating factors. Non-responders underwent a diagnostic local anesthetic nerve block test. Patients who responded with transient symptomatic relief were treated by local infiltration of corticosteroids. Surgical intervention was reserved for patients with positive nerve block test, who did not respond to nonoperative measures.


RESULTS
A negative nerve block test ruled out the diagnosis of MP in 6/86 patients. Of 79 patients with MP, 21 responded to the initial nonoperative treatment and 48 patients responded to local corticosteroids. 3 of the remaining 10 patients underwent surgery (nerve transection 2, neurolysis 1). During an average of 3 (1-13) years of follow-up, symptoms consistent with MP did not recur in any of the 72 patients in whom symptoms had resolved after treatment.


CONCLUSIONS
The algorithm used proved to be useful in the management of spontaneous meralgia paresthetica.
Haim
Amir
A
Department of Orthopedic Surgery "B", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Israel. amirhaim@gmail.com
Pritsch
Tamir
T
Ben-Galim
Peleg
P
Dekel
Samuel
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001623:Betamethasone / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D020428:Femoral Neuropathy / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D009408:Nerve Compression Syndromes / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D010292:Paresthesia / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies
D005938:Glucocorticoids; D001623:Betamethasone