The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Rees G Cosgrove - One of the best experts on this subject based on the ideXlab platform.
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spinal cord stimulation for treatment of Meralgia Paresthetica
Pain Physician, 2005Co-Authors: Steven A Barna, Melvin M Hu, Carlos Buxo, Jason Trella, Rees G CosgroveAbstract:Background Meralgia Paresthetica is a clinical syndrome of pain, dysesthesia or both, in the anterolateral thigh. It is associated with an entrapment mononeuropathy of the lateral femoral cutaneous nerve. Diagnosis of Meralgia Paresthetica is typically made clinically and is based on the characteristic location of pain or dysesthesia, sensory abnormality on exam, and absence of any other neurological abnormality in the leg. The majority of patients with Meralgia Paresthetica respond well to conservative treatment. Objective To present a case of intractable Meralgia Paresthetica in which conservative treatment options failed but which was successfully treated with a spinal cord stimulator. Case report A 44-year-old woman presented to the pain clinic with a one-year history of bilateral anterolateral thigh pain. History, physical exam, and diagnostic work-up were consistent with Meralgia Paresthetica. Multiple medications, physical therapy, and chiropractic therapy were not successful for this patient. In addition, local anesthetic/steroid injection of the lateral femoral cutaneous nerve provided only short-term relief. Ultimately, a spinal cord stimulator was implanted after a successful temporary percutaneous trial. Two months after the implantation, she continued to have 100% pain relief, worked full-time, was physically active, and no longer required any pain medication including opioids. Conclusion An implanted spinal cord stimulator may be an ideal treatment for intractable Meralgia Paresthetica after conservative treatments have failed because it is not destructive and can always be explanted without significant permanent adverse effects.
Ira M Goldstein - One of the best experts on this subject based on the ideXlab platform.
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Meralgia Paresthetica after spine surgery on the jackson table
Journal of Spinal Disorders & Techniques, 2018Co-Authors: Nitin Agarwal, Jaydev B Mistry, Preeya V Khandge, David R Hansberry, Ira M GoldsteinAbstract:: Meralgia Paresthetica is a non-life-threatening neurological disorder characterized by numbness, tingling, and burning pain over the anterolateral thigh due to impingement of the lateral femoral cutaneous nerve. This disorder has been seen in patients with diabetes mellitus and obesity, but has also been observed in patients after procedures such as posterior spine surgery, iliac crest bone grafts, lumbar disk surgery, hernia repair, appendectomies, and pelvic osteotomies that ultimately lead to compression or damage to the lateral femoral cutaneous nerve. Overall, permanent sequelae of Meralgia Paresthetica are rare, however, some cases do require intervention.
P Seror - One of the best experts on this subject based on the ideXlab platform.
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somatosensory evoked potentials for the electrodiagnosis of Meralgia Paresthetica
Muscle & Nerve, 2004Co-Authors: P SerorAbstract:The aim of this study was to evaluate the diagnostic utility of somatosensory evoked potential (SSEP) studies of the lateral femoral cutaneous nerve (LFCN) in assessing patients with Meralgia Paresthetica. Twenty-one consecutive patients with unilateral Meralgia Paresthetica, as defined clinically (sensory impairment of lateral aspect of the thigh) and electrodiagnostically (abnormal sensory nerve conduction), and 21 control subjects were studied with two SSEP methods. SSEPs were elicited by stimulation of the LFCN below the anterior superior iliac spine (ASIS stimulation) and by cutaneous stimulation of the lateral aspect of the distal third of the thigh (thigh stimulation). Abnormalities were defined by the SSEP interside latency difference, interside amplitude ratio, or an absent response. The SSEP with ASIS stimulation had a sensitivity of 5% and a specificity of 95%, whereas with thigh stimulation it had a sensitivity of 52% and a specificity of 76%. Overall, SSEP after ASIS stimulation had no diagnostic value. Recording of the SSEP after thigh stimulation is recommended in obese patients only when sensory nerve conduction cannot be determined.
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lateral femoral cutaneous nerve conduction v somatosensory evoked potentials for electrodiagnosis of Meralgia Paresthetica
American Journal of Physical Medicine & Rehabilitation, 1999Co-Authors: P SerorAbstract:: The aim of this study is to compare sensory nerve conduction with somatosensory evoked potentials of the lateral femoral cutaneous nerve to determine which is the most reliable electrodiagnostic method to assess Meralgia Paresthetica. Thirty patients with unilateral clinically defined Meralgia Paresthetica and 30 controls were studied with both methods. The main outcome measures were sensory action potential side-to-side amplitude ratio, somatosensory evoked potentials side-to-side latency difference, and side-to-side amplitude ratio. Sensory nerve conduction was abnormal in all patients: only four participants had abnormal somatosensory evoked potentials with double derivation (Fz/Cz and Ci/Cc) recording, and eight participants had abnormal findings with Fz/Cz derivation. Overall, this study demonstrates that sensory nerve conduction is the more reliable method for Meralgia Paresthetica electrodiagnosis. In fact, only very serious nerve damage regularly induces abnormal somatosensory evoked potentials, which is not recommended for routine electrodiagnostic study of Meralgia Paresthetica.
George J Crystal - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of Meralgia Paresthetica with pulsed radiofrequency of the lateral femoral cutaneous nerve
Pain Physician, 2009Co-Authors: Cyril Philip, Kenneth D Candido, Ninos J Joseph, George J CrystalAbstract:BACKGROUND: Meralgia Paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve caused by entrapment or compression of the nerve as it crosses the anterior superior iliac spine and runs beneath the inguinal ligament. OBJECTIVE: We describe the first reported use of pulsed radiofrequency neuromodulation to relieve the intractable pain associated with Meralgia Paresthetica. CASE REPORT: A 33-year-old morbidly obese female with a history of lower back pain and previous spinal fusion presented with sensory dysesthesias and paresthesias in the right anterolateral thigh, consistent with Meralgia Paresthetica. Temporary relief occurred with multiple lateral femoral cutaneous nerve and fascia lata blocks at 2 different institutions. The patient expressed dissatisfaction with her previous treatments and requested "any" therapeutic intervention that might lead to long-lasting pain relief. At this time, we located the anterior superior iliac spine and reproduced concordant dysesthesia. Pulsed radiofrequency was then undertaken at 42 degrees C for 120 seconds followed by dexamethasone and bupivicaine. The patient reported exceptional and prolonged pain relief at 6-month follow-up. LIMITATIONS: Since this case report is not a prospective, randomized, controlled or blinded study, no conclusions may be drawn from the results attained on behalf of this single individual. Additional, larger group analyses studying this technique while eliminating bias from patient variables would be essential prior to assuming any validity to using pulsed radiofrequency techniques of neuromodulation for managing peripheral neuropathic pain processes. CONCLUSION: The patient had experienced long-standing pain that was recalcitrant to conservative/pharmacologic therapy and multiple nerve blocks with local steroid instillations. A single treatment with pulsed radiofrequency resulted in complete and sustained cessation of pain. No side effects were evident. Pulsed radiofrequency of the LFCN may offer an effective, low risk treatment in patients with Meralgia Paresthetica who are refractory to conservative medical management or are unwilling or unfit to undergo surgery.
Steven A Barna - One of the best experts on this subject based on the ideXlab platform.
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spinal cord stimulation for treatment of Meralgia Paresthetica
Pain Physician, 2005Co-Authors: Steven A Barna, Melvin M Hu, Carlos Buxo, Jason Trella, Rees G CosgroveAbstract:Background Meralgia Paresthetica is a clinical syndrome of pain, dysesthesia or both, in the anterolateral thigh. It is associated with an entrapment mononeuropathy of the lateral femoral cutaneous nerve. Diagnosis of Meralgia Paresthetica is typically made clinically and is based on the characteristic location of pain or dysesthesia, sensory abnormality on exam, and absence of any other neurological abnormality in the leg. The majority of patients with Meralgia Paresthetica respond well to conservative treatment. Objective To present a case of intractable Meralgia Paresthetica in which conservative treatment options failed but which was successfully treated with a spinal cord stimulator. Case report A 44-year-old woman presented to the pain clinic with a one-year history of bilateral anterolateral thigh pain. History, physical exam, and diagnostic work-up were consistent with Meralgia Paresthetica. Multiple medications, physical therapy, and chiropractic therapy were not successful for this patient. In addition, local anesthetic/steroid injection of the lateral femoral cutaneous nerve provided only short-term relief. Ultimately, a spinal cord stimulator was implanted after a successful temporary percutaneous trial. Two months after the implantation, she continued to have 100% pain relief, worked full-time, was physically active, and no longer required any pain medication including opioids. Conclusion An implanted spinal cord stimulator may be an ideal treatment for intractable Meralgia Paresthetica after conservative treatments have failed because it is not destructive and can always be explanted without significant permanent adverse effects.
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Spinal cord stimulation for treatment of Meralgia Paresthetica.
Pain Physician, 2005Co-Authors: Steven A Barna, Melvin M Hu, Carlos Buxo, Jason Trella, G. Rees CosgroveAbstract:BACKGROUND: Meralgia Paresthetica is a clinical syndrome of pain, dysesthesia or both, in the anterolateral thigh. It is associated with an entrapment mononeuropathy of the lateral femoral cutaneous nerve. Diagnosis of Meralgia Paresthetica is typically made clinically and is based on the characteristic location of pain or dysesthesia, sensory abnormality on exam, and absence of any other neurological abnormality in the leg. The majority of patients with Meralgia Paresthetica respond well to conservative treatment. OBJECTIVE: To present a case of intractable Meralgia Paresthetica in which conservative treatment options failed but which was successfully treated with a spinal cord stimulator. CASE REPORT: A 44-year-old woman presented to the pain clinic with a one-year history of bilateral anterolateral thigh pain. History, physical exam, and diagnostic work-up were consistent with Meralgia Paresthetica. Multiple medications, physical therapy, and chiropractic therapy were not successful for this patient. In addition, local anesthetic/steroid injection of the lateral femoral cutaneous nerve provided only short-term relief. Ultimately, a spinal cord stimulator was implanted after a successful temporary percutaneous trial. Two months after the implantation, she continued to have 100% pain relief, worked full-time, was physically active, and no longer required any pain medication including opioids. CONCLUSION: An implanted spinal cord stimulator may be an ideal treatment for intractable Meralgia Paresthetica after conservative treatments have failed because it is not destructive and can always be explanted without significant permanent adverse effects.