Ultrasound-guided treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy): technical description and results of treatment in 20 consecutive patients

Alberto Tagliafico, Giovanni Serafini, Francesca Lacelli, Nadia Perrone, Valtero Valsania, Carlo Martinoli
Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine 2011, 30 (10): 1341-6

OBJECTIVES: The purposes of this study were to describe a technique for treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy) using ultrasound guidance and to report the results of treatment.

METHODS: Twenty consecutive patients (7 male and 13 female; age range, 23-66 years; mean, 39 years) with meralgia paresthetica confirmed by electromyography were treated with perineural injection of 1 mL of methylprednisolone acetate (40 mg/mL) and 8 mL of mepivacaine, 2%, under direct ultrasound guidance. Main outcome measures included the technical success of the procedure, visual analog scale score for the lateral femoral cutaneous nerve (pain, burning sensation, and paresthesia), and visual analog scale global quality of life score.

RESULTS: Technical success (successful nerve block at the distribution of the lateral femoral cutaneous nerve) was achieved in all patients. Five patients felt slight sharp pain during needle insertion. The symptoms in 16 patients (80%) diminished progressively after the first week. The 4 remaining patients (20%) required a further perineural injection. The symptoms disappeared in all patients 2 months after injection (mean visual analog scale score ± SD for lateral femoral cutaneous neuropathy at baseline, 8.1 ± 2.1; at 2 months, 2.1 ± 0.5; t = 6.2; P < .001). The mean visual analog scale quality of life scored decreased from 6.9 ± 3.2 to 2.3 ± 2.5 (t = 5.3; P < .002).

CONCLUSIONS: Treatment of meralgia paresthetica with ultrasound-guided perineural injections resulted in substantial symptom relief in most patients 2 months after injection. Randomized placebo-controlled trials of this treatment should be considered in the future.

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