Differential etiological diagnosis of meralgia paresthetica: a concise review

Introduction: Meralgia paresthesia (PM) is a condition in which there is compression of the lateral femoral cutaneous nerve, with its entrapment. Clinically it presents with burning pain and dysesthesia in the anterolateral region of the thigh. MP tends to occur more frequently in women and is more common from the fourth to fifth decade of life with an incidence of 3 to 4 per 10,000 individuals. Objectives: Due to the multiple different etiological diagnoses of PM, we aim to show systemic and non-systemic causes and explain tests of the condition. Methods: This abstract is a non-systematic review. All articles used were searched in the public databases PubMed, Medline, ScienceDirect, SciELO and Cochrane. We searched for terms related to meralgia paresthesia, selecting the most relevant articles available in English or Portuguese. Results: The presentation of MP is usually unilateral, with subacute onset (days to weeks), and may be associated with prolonged hip extension and flexion relief. There is a wide spectrum of non-systemic diseases that may be responsible for the development of PM, from surgical sequelae to direct mechanical compression of the nerve. Besides, diabetes mellitus and Covid-19 infection may be systemic causes of the condition. Diabetes mellitus is associated with endothelial dysfunction and peripheral neuropathy. Covid-19 increases the inflammatory state and consequent pain of the intensive care unit patient causing neurological sequelae. On the exams, there is the neurodynamic test of the femoral nerve and the pelvic compression test. However, other diagnostic approaches are used because they present greater specificity, such as somatosensory evoked potentials, high-resolution ultrasonography and magnetic resonance imaging. Conclusion: In short, the etiological diagnosis of PM is important, since treatment varies according to the cause. In addition, it helps to expedite the process of diagnosis, investigation, treatment and follow-up of these patients.