He saw a different GP 1 year ago and was diagnosed with sciatica. The numbness resolved after a few weeks. This episode started again around 2-3 weeks ago.
His main complaint was numbness on the lateral part of his thigh. It tended to get worse with prolonged walking and standing. There was no associated weakness on his lower limb. There was no back pain
On examination, you mapped out the area of sensory change on his left lateral thigh. The lower leg neurological examination was normal. The straight leg raise was negative.
Question 1
What is your diagnosis ?
Question 2
What can you do about it ?
Answer 1
This is lateral cutaneous nerve of thigh entrapment. The nerve gets trapped when it passes through the inguinal ligament. It is a pure sensory nerve so motor function is not affected.
It is more common in obese people and also associated with diabetes.
Answer 2
Nothing. There is really not much you can do. You tell them to lose weight and you warn them about wearing tight pants or belt which may compress on the nerve. Most of the time, the symptom resolves by itself. In some occasions, it persists and anti epileptic may help.
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