The lateral cutaneous nerve is a purely sensory branch arising from the lumbar plexus (L2-L3). It passes obliquely across the iliac muscle, and enters the thigh under the lateral part of the inguinal ligament. It supplies the skin over the anterolateral aspect of the thigh. Meralgia paresthetica is a condition caused by entrapment of this nerve as it passes through the opening between the inguinal ligament and its attachment 1 - 2 cm medial to the anterior superior iliac spine. Numbness is the earliest and most common symptom. Patients also complain of pain, paresthesias (tingling and burning) and often touch - pain - temperature hyp-esthesia over the anterolateral aspect of the thigh. The condition occurs particularly in obese individuals who wear constricting garments (e.g., belts, tight jeans, corsets and camping gear). Intra-abdominal or intra-pelvic processes may directly impinge on the nerve during its long course; the condition can also be due to abdominal distension (as a result of ascites, pregnancy, tumor, or systemic sclerosis), and may follow an intertrochanteric osteotomy or removal of an iliac crest bone graft if it is taken too close ( 2 cm) to the anterior superior iliac spine. The differential diagnosis includes the following conditions:
Femoral neuropathy Sensory changes tend to be more anteromedial than in meralgia paresthetica, sometimes extending to the medial malleolus and the big toe
Nerve compression by There are concomitant gastrointestinal or genito-
an abdominal or pelvic urinary symptoms tumor
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