Bei brennenden, einschießenden Schmerzen oder Hypästhesien an der
Oberschenkelvorderseite sollte differenzialdiagnostisch auch an eine Meralgia paraesthetica
gedacht werden. Diese Kompressionsneuropathie des N. cutaneus femoris lateralis
wird
differenzialdiagnostisch mitunter nicht berücksichtigt, lässt sich jedoch in der
Regel
klinisch diagnostizieren. Das therapeutische Spektrum reicht von konservativen Maßnahmen
bis
zur operativen Dekompression.
Abstract
Meralgia paraesthetica (MP) is a mononeuropathy of the lateral femoral cutaneous nerve
(LFCN), typically caused by compression at the level of the inguinal ligament.
The
syndrome presents with burning pain, paraesthesia, and hypaesthesia in the anterolateral
thigh, without motor deficits. The LFCN, derived from the L2–L3 spinal nerves,
is
vulnerable to compression or traction due to its anatomical course under the inguinal
ligament. MP may result from both traumatic (e.g., surgery, injury) and non-traumatic
causes (e.g., obesity, pregnancy, tight clothing). In some cases, the etiology
remains
unknown. Diagnosis is primarily clinical and based on patient history and physical
examination. Imaging techniques and electroneurography can support diagnostic
confirmation in unclear cases. If symptoms extend beyond the typical LFCN territory,
are
bilateral, or are accompanied by motor or reflex abnormalities, differential diagnoses
–
including radiculopathy, involvement of adjacent nerves, or anatomical variations
of the
LFCN – should be considered. Initial treatment is conservative and includes patient
education, avoidance of precipitating factors, pharmacological pain management
(NSAIDs,
opioids, co-analgesics), and physiotherapy. Diagnostic and therapeutic nerve blocks
using local anesthetics can provide symptom relief and aid diagnosis. Non-invasive
adjunct therapies such as transcutaneous electrical nerve stimulation (TENS), Botulinum
toxin A injections, acupuncture, and kinesio taping may offer additional pain relief
in
selected patients. In refractory cases, minimally invasive procedures including
radiofrequency therapy or surgical decompression of the LFCN may be considered.
Schlüsselwörter
N. cutaneus femoralis lateralis - Neuropathie - Nervenkompressionssyndrom - Neurolyse
- Neurektomie
Keywords
lateral femoral cutaneous nerve - neuropathy - nerve compression syndrome - neurolysis
- neurectomy
