What Is the Lateral Femoral Cutaneous Nerve?
Lateral femoral cutaneous neuritis, also known as paresthesia femoral pain, Bernhardt's disease, and Roth disease, is the most common clinical dermatoneuritis, and is a disease of paresthesia of the lateral femoral skin. The lateral femoral cutaneous nerve system is a pure sensory nerve that originates from the lumbar plexus and consists of the anterior branches of L2 and L3 nerve roots. After extending from the outer edge of the psoas major muscle, it enters the subcutaneous tissue 3 to 5 cm below the inguinal ligament and is distributed in Lateral femoral skin. Part of the normal human femoral cutaneous nerve originates from the reproductive femoral or femoral nerve. If the lateral femoral cutaneous nerve is affected by compression or trauma during this nerve stroke, lateral femoral cutaneous neuritis may occur.
Basic Information
- nickname
- Paresthesia, Bernhardt disease
- Visiting department
- Neurology
- Multiple groups
- 20 ~ 50 year old obese men
- Common symptoms
- Paresthesia in the lower 2/3 area of the anterolateral femur, such as numbness, antagonism, tingling
Causes of lateral femoral cutaneous neuritis
- 1. Compression of the lateral femoral cutaneous nerve
- The lateral femoral cutaneous nerve travels through the lateral border of the psoas major muscle to the groin at a large angle. It passes through the groin fascia and is easy to be injured. The compression site is usually at the anterior superior iliac spine. Common causes are: spinal deformity, hypertrophic spondylitis, spina bifida, lumbar vertebralization, pregnancy, pelvic tumors, retroperitoneal tumors, inguinal hernias, and herniated discs, all of which can cause the disease.
- 2. Trauma or infection
- Such as: lumbar myositis, pelvic inflammatory disease, neurosyphilis, appendicitis, herpes zoster sequelae, etc. can induce the disease.
- 3. Other
- Such as diabetic mononeuropathy is easy to affect the nerve, drug poisoning, alcoholism, cold and humidity are common causes of this disease, some patients have unknown etiology of injury.
- There are no special changes except for mild inflammatory cell infiltration around small dermal vessels. Nerve examination revealed nerve swelling, infiltration of inflammatory cells around the nerve, and neurodegeneration.
Clinical manifestations of lateral femoral cutaneous neuritis
- More common in obese men 20 to 50 years old. Most of them are affected on one side, which is manifested as paresthesia in the lower 2/3 area of the anterolateral side of the femur, such as numbness, antagonism, tingling, burning sensation, coldness, and heaviness. It can be exacerbated by physical labor and standing too long, and the symptoms can be relieved after rest. On examination, there may be varying degrees of superficial sensation diminished or absent, mainly due to decreased pain and temperature sensation and pressure sensation. A few patients may have hypopigmentation or hyperpigmentation. In some patients, the skin may be mildly thin, slightly dry, and the hairs reduced. Some patients have tenderness on the outside of the groin and no symptoms of motor nerve involvement such as muscle weakness and muscle atrophy. The disease is usually unilateral, with a few bilateral cases. The course of chronic disease is mild and severe, and it does not heal from a constant month to many years.
Examination of lateral femoral cutaneous neuritis
- Dermatome stimulation somatosensory evoked potential examination, especially the contrast of the two sides has diagnostic significance. This nerve is a pure sensory nerve. Electromyographic examination is meaningless, and nerve conduction velocity measurement is limited by the site.
Diagnosis of lateral femoral cutaneous neuritis
- The diagnosis of this disease is mainly based on medical history and physical examination.
Differential diagnosis of lateral femoral cutaneous neuritis
- Clinically, it needs to be distinguished from femoral neuropathy and L2 radiculopathy. Femoral neuropathy can affect both the sensory and motor branches, muscle weakness and muscle atrophy in the corresponding innervation zone. Electromyograms show neurogenic damage to the quadriceps, slowed femoral nerve conduction velocity, and reduced amplitude. L2 radiculopathy is rare in the clinic, and the sensory disturbance is distributed in the anterior medial thigh, which can be accompanied by weakness of the iliopsoas and biceps femoris. In addition, it is distinguished from early leprosy based on a comprehensive analysis of epidemiological history, disease history, and pathological biopsy, including nerve fiber staining and acid-fast bacilli.
Lateral femoral cutaneous neuritis treatment
- The treatment of lateral femoral cutaneous neuritis first lies in identifying the primary disease and actively treating the primary disease, and removing the stimulation of the nerve, such as treating diabetes, arteriosclerosis, poisoning, etc., obese people lose weight, and alcoholics quit drinking.
- In addition, symptomatic treatment can be given vitamin B 1 , B 2 , B 12 or corticosteroids to nourish nerves and eliminate inflammation.
- Severe pain can also be given analgesics or local closure. Lateral femoral cutaneous nerve injection therapy: At the sartorius muscle about 10cm below the anterior superior iliac spine, use a 12-gauge needle to pierce about 3 to 4cm vertically, and then inject vitamin B 1 or a mixed solution with vitamin B 12 daily. 1 5 to 10 times is a course of treatment.
- Try physical therapy, acupuncture, massage and massage may be effective in some cases. If the condition is severe and it is difficult to relieve the unknown cause, surgery can be performed to cut the nerve or perform nerve release.