A rare presentation of meralgia paraesthetica in limb girdle muscular dystrophy

Scott Med J. 2018 Feb;63(1):25-27. doi: 10.1177/0036933017707162. Epub 2017 May 7.

Abstract

A 44-year-old female with paraesthesia and pain on the left anterolateral thigh who had been diagnosed with limb-girdle muscular dystrophy by electromyography and muscle biopsy is presented. Neurological examination revealed atrophy of the proximal muscles of both shoulders, plus pseudo hypertrophy of both calves. Electromyography exhibited a myopathic pattern. Musculoskeletal ultrasound imaging demonstrated a fusiform nerve swelling below the inguinal ligament suggesting lateral femoral cutaneous nerve compression, consistent with meralgia paraesthetica. Treatment with a perineural injection of betamethasone dipropionate and betamethasone sodium phosphate combination, and prilocaine-HCl, under ultrasound guidance, was performed. Symptoms resolved within 6 h. At 3-week follow-up, the patient was asymptomatic, and there was no paraesthesia or pain on examination. In this case, ultrasound-guided perineural injection of the lateral femoral cutaneous nerve with local anaesthetics and steroid served both diagnostic and therapeutic functions.

Keywords: Meralgia paraesthetica; muscular dystrophy; ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anesthetics, Local / administration & dosage*
  • Anti-Inflammatory Agents / administration & dosage*
  • Betamethasone / administration & dosage
  • Betamethasone / analogs & derivatives*
  • Electromyography
  • Female
  • Femoral Neuropathy
  • Humans
  • Muscular Dystrophies, Limb-Girdle / diagnostic imaging
  • Muscular Dystrophies, Limb-Girdle / physiopathology*
  • Nerve Block
  • Nerve Compression Syndromes / diagnosis*
  • Nerve Compression Syndromes / drug therapy
  • Nerve Compression Syndromes / physiopathology
  • Neural Conduction / physiology
  • Prilocaine / administration & dosage*
  • Thigh / innervation*
  • Treatment Outcome

Substances

  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Prilocaine
  • betamethasone sodium phosphate
  • betamethasone-17,21-dipropionate
  • Betamethasone