Meralgia paraesthetica

Meralgia paraesthetica (synonym disease Rota - Bernhardt - affected external cutaneous nerve of thigh (n, cutaneus femoris lateralis), accompanied by pain and paresthesia (tingling, numbness and burning) prednamerennoe of the thigh one leg, rarely both. The disease develops more often in the elderly. The reasons are: vascular changes that violate the power nerve (atherosclerosis and endarteritis), venous congestion in the nerve (varicose veins of small pelvis or lower limbs), nerve injury and metabolic disorders.

The field of reduction of pain and sensitivity, and paresthesia in the upper third of the thigh (painted black).

Pain occurs when standing, walking, sometimes when lying down. At the beginning of the disease they are localized in the upper third of the thigh, and then distributed throughout nerve; in these areas is a decrease of pain and sensitivity (Fig.), most nerve pressure insensitive. Disease develops gradually, long can take place, sometimes the pain can permanently disappear, and then reappear.
Treatment of the underlying disease. Injections of vitamins: cyanocobalamin (B12) intramuscularly in a dose of 200 mcg 20 injections and thiamin-bromide (B1) intramuscularly 6% solution of 2 ml 25 injection; analgesics, exercise therapy, massage, darsonvalization, radon baths. It is necessary to follow the work of the intestine. In long-term recurrent cases shown radiotherapy.

Meralgia paraesthetica (gr. meros - thigh, algos - pain; synonym disease Rota - Bernhardt) is a syndrome that occurs in an isolated lesion n. cutaneus femoris lateralis and characterized by paresthesia and pain spreading across the front to the outside of the thigh.
The etiology of the disease is not clear, its causes are different. The most common of these are, apparently, vascular changes in nerve (atherosclerosis and endarteritis)violates the power nerve, and venous congestion in it (varicose veins limbs and small pelvis). In old age meralgia paraesthetica often develops.
Postmortem data is scarce due to the small number of autopsies, in which were found the phenomenon of perineuritis with degenerative nerve fibers.
Over and symptoms. Usually appear numbness poured tingling, feeling pressure to certain parts of the hip, less burning. Later, the paresthesia join blunt mild pain. Pain and paresthesia appear when standing or walking, and the intensity is in direct proportion to the length of time standing or walking.
At the beginning of the disease in a sitting or lying position, when bent limbs all these phenomena are rapidly but then can have more or less permanent. Most nerve pressure insensitive. Places of paresthesia correspond to the distribution of a nerve at the hip, but more often localized in the upper part of the thigh or start in a very limited space (for example, in a place pressure solid object in your pocket) and then distributed on his thigh. In rare cases the border of paresthesia and especially pain goes beyond the propagation of the nerve. Objective examination of the affected area, in most cases, there was a decrease of sensitivity (pain, tactile), usually not reaching a large extent. Sometimes, on the contrary, it is more or less pronounced hyperesthesia, often aggravated by stroking the affected area by hand, from тренbя clothes.
Disease progression gradual, long, paresthesia, and light pain appear and disappear, sometimes for a long time.
Treatment. It is necessary to treat the underlying disease (atherosclerosis, endarteritis, gout). Recommend injections of vitamin B1 (6% 2 ml, 20 injections); the tendency to obesity and sedentary work - curative gymnastics. Satisfactory results give paradisaea and darsonvalization, regulating the function of the peripheral vessels, as well as radon baths. In more severe cases, you can use x-ray treatments.