Nozaki Toshiki, Morimoto Daijiro, Kim Kyongsong, Kitamura Takao, Kokubo Rinko, Yamaguchi Fumio, Isu Toyohiko, Morita Akio
Department of Neurological Surgery, Nippon Medical School.
No Shinkei Geka. 2017 May;45(5):431-436. doi: 10.11477/mf.1436203528.
A 60-year-old woman presented with a 1-year history of pain and numbness in the left anterolateral thigh. The symptoms aggravated on walking and standing. Her visual analogue scale(VAS)score was 7.1/10. Tinel's like sign was positive over the lateral femoral cutaneous nerve(LFCN), in the inguinal ligament region. LFCN block at the trigger point, in the inguinal ligament, resulted in relief of the symptoms and we diagnosed meralgia paresthetica(MP), which is the entrapment neuropathy of the LFCN. Initially, we performed observation therapy with oral medication and LFCN blocks. However, these treatments failed to relieve the symptoms. Therefore, we performed neurolysis with a microscope under local anesthesia. The symptoms improved immediately after surgery and her VAS score of thigh symptom improved from 7.1 to 1.9 after 3 months. Conservative and surgical treatment for MP generally yield good outcome and we should pay attention to the MP as a differential diagnosis for thigh numbness and pain.
一名60岁女性，左大腿前外侧疼痛麻木1年。行走和站立时症状加重。其视觉模拟评分（VAS）为7.1/10。在腹股沟韧带区域，股外侧皮神经（LFCN）处Tinel征样表现阳性。在腹股沟韧带处触发点行LFCN阻滞可缓解症状，我们诊断为感觉异常性股痛（MP），即LFCN卡压性神经病。最初，我们采用口服药物和LFCN阻滞进行观察性治疗。然而，这些治疗未能缓解症状。因此，我们在局部麻醉下用显微镜进行神经松解术。术后症状立即改善，3个月后大腿症状的VAS评分从7.1降至1.9。MP的保守和手术治疗通常效果良好，我们应注意将MP作为大腿麻木和疼痛的鉴别诊断。
