Meralgia Paresthetica and Hyporeflexia!

Dear Doctor,
I was just diagnosed with Meralgia Paresthetica.  I have parethesias, pain concentrated in the outside mid thigh, reduced urinary pressure, numbness, spotty loss of sensation, and reduced reflexes in the knee.  I've also experienced some shooting/electric sensation pains from the hip.  This problem started in April 1999, when I awakened from sleep suffering from numbness and no pain.  At that time, I had a large fibroid tumor aprox. 10cms. in diameter.  I had a myomectomy in late June 1999, and awoke from sleep two weeks post surgery with severe pain in the lower outside thigh.  I have a clotting disorder and possible Connective Tissue Disorder, and fearing a blood clot, saw my PCP.  She diagnosed it as originating from my lumbar spine-I had the reflex loss,back stiffness, and lumbar inflammation.  I was put on Naprosyn and took this therapy for two(2) months.  I felt better, but the problem was still there, and the PCP sent me for Lumbar Xrays and Lumbar MRI.  The Xrays showed mild arthritis and nothing diagnostic in the MRI.  I was then referred to an orthopedist.  He wanted to determine if I had radiculopathy and referred me to a neurologist for an EMG.  The neurologist diagnosed Meralgia Paresthetica.  What I would like to know-given the extent of my symptoms-would this be classified as severe? Could a blood clot in either the abdomen or thigh cause this problem, not just entrapment/compression of the illial nerve?  And would surgery be an option for me because of onset less than a year, reflex loss, and continuing symptoms?  Would I regain the reflex, reduce/eliminate the nerve pain, and possibly restore sensation?  Thank you for any information you can offer.
Sincerely,
Ginny

[CCF neuro MD MM]

Based on the symptoms you describe this does sound like a severe case of meralgia parasthetica, this specific problem is caused by compression of the nerve under the inguinal loigament and is unlikely to be caused by a blood clot in the abdomen or thigh.
If this is indeed meralgia parasthetica, surgery should be an option and this would be relatively simple as the problem is located very superficially in the groin / inguinal area.
If successful there should be resolution of pain and recovery of sensation, obviously it is impossible to predict recovery in an individual case but this is the purpose of surgery.

[ginny]

Thank you for your prompt and informative response.

[Sendi]

Dear doctor,
I am 36 years old mother of two girls (5 and 11 years old). Soon after birth of my 5 years old daughter my health trouble started. A strange pain occured in the groin of the right leg and gradually the pain increased. Various doctors tried to find out the cause and finally after several months I was told to have "Meralgia Paresthetica" - (Bernhardt - Roth Syndrome). At the beginning I was treated with cortisone and it helped somewhat, but very soon the pains became so severe that I had to undertake the surgery on Januay 4,1997. (Decompressio nervi cutanei femoralis lateralis l.dex). Post operation period was fine - the pain was gone exept that I still feel numbness and loss of sensation at the operated area so I went back to my normal activities(housework,fitness,skiing,swimming etc.) but nobody warned me that some of those activities I was not supposed to do at all (stretching i.e.). So again the pain returned slowly into my right leg and gradually appeared in my left leg as well (April 1999). The dyagnosis was the same. First I was given Xylocain injection directly into the nerve - the pain relieved for only 24 hours: On July 27.1999 I have undergone another surgery but this time on the left side of groin(Decompressio nervi cutanei femoralis lateralis sinistra). Only a  month after this second surgery I felt pains in the operated leg and gradually the pains occured in my right leg as well. Slowly the pain increased and again I went through cortisone therapy(for a month) which helped some but not entirely.In meantime I have changed my residence and doctor and his dyagnosis reads as follows: Post operation recidiva bilateral meralgia paresthetica. He prescribed me Neurontin. I have started with 300mg daily,have increased dosage to 600, 900 and finally 1200mgs daily(4 pills). During that adjustment period(one month) I went through hell (I feltsleepy,dizzy,retarded,had amnesia,nausea etc.)but gradually my pains became less and less severe and finally are now gone as well as side effects. I was told to stay at this dosage (1200mgs daily) for another 1 and 1/2 month and then will start reducing it backwards until I reach the dosage at which no pain will occur. In meantime I have checked all correspondence relating to neurology and neurosurgery (questions and responses) on the Internet pages (MedHelp)so I am well acquanted with other people's similar problems as well as with Neurontine. However, I couldn't find one similar case to mine (double operation on both side of groin) and am wondering whether the Neurontine is the onliest solution to my problem: Will I have to take him lifetime and are there long term side effects to this drug? What kind of activities can I perform at all - now when I am without pain? Besides Neurontine, does any physical therapy can help as well? I need to know this because my everydays activities(house,kids etc.) require my full physical engagement. Both doctors agreed that third operation doesn't come into consideration and I wonder if you can suggest me other solution rather than Neurontine?
In advance thanks for your reply,                 Sendi

[jeff]

I have just been diagnosed with Meralgia Paresthetica.  What is it?  How is it treated?  What is the prognosis?

[ENGRACIA MARTINEZ DE LARA]

YO PADESCO DE MERALGIA PARESTESICA, NINGUN ANALGESICO ME HABIA LOGRADO QUITAR EL ARDOR Y ADORMECIMIENTO Y MUCHO DOLOR EN LA PARTE LATERAL EXTERNA DE MUSLO DERECHO. POSTERIORMENTE MI ESPOSO QUE PRACTICA LA MEDICINA COMPLEMENTARIA ME RECETO VITAMINA B6 O SEA LA PYRIDOXINA A RAZON DE 200 MG DOS VECES AL DIA Y DESDE ENTONCES ME DESAPARECIO EL DOLOR AUNQUE LO SIGO TOMANDO PERO ESTOY MUY MEJORADO. ESTO LO HIZO POR LA RELACION QUE GUARDA EN FISIOPATOLOGIA CON EL SINDROME (syndrome) DE TUNEL CARPIANO.

[Jeffrey John]

Since I have been taking Neurontin, my amnesia has become much worse. I cannot remember whole days. I take approximately 1800mgs for my chronic neuropathic pain. Is there a connection here?

[anne64]

A related discussion, meralgia paresthetica was started.