Meralgia Paresthetica, locating the lateral femoral cutaneous nerve (LFCN) with elektro-stimulation followed by a therapeutic injection of methylprednisolone/lidocaïne (M/L), a double-blind randomized placebo-controlled clinical trial

Meralgia paresthetica (MP) is a mononeuropathy of the lateral femoral cutaneous
nerve (LFCN) characterized by pain, numbness and tingling in the anterolateral
aspect of the thigh. It can be organized as an entrapment neuropathy with a
long list of differential diagnosis. Frequently its cause is spontaneous
which include mechanical factors such as obesity, wearing a tight belt and
other conditions associated with increased intra-abdominal pressure ( 1). The
incidence of meralgia paresthetica in the Rotterdam area is 4.3 per 10.000 a
year. (2). In a previous study five different types of anatomical variation
were described.(3) For interventional treatment of meralgia paresthetica such
as local injections with anesthetics and corticosteroids the evidence is
limited but seems beneficial however it has previously been performed in a
blind fashion using an anatomical landmark. Locating a nerve with
electrostimulation is easily applicable and usually well tolerated by
patients. It does not require a radiologist or neurologist specialized in
ultrasound.(4) This therapy can be used for a more accurate localization and a
more accurate blockade of the LFCN.*

The aim of this study is to analyse the analgetic effect of a local injection
in the lateral femoral cutaneous nerve ( LFCN) with
methylprednisolone/lidocaine (M/L) after localisation through elektro
stimulation VS placebo. In this trial we hope to objectify:
Therapeutic value of a localized injection with M/L in MP patients, when
localized by elektro-stimulation.

This will be a single centered double-blind randomized placebo-controlled
intervention study.

Patients will be injected with 2,5 ml methylprednisolone/lidocaine or 2,5 ml
saline 0,9% 1 cm medial of the anterior superior iliac spine after
localisation with electro stimulation of the LFCN.

Nature and extent of the burden and risks associated with participation,
benefit and group relatedness:
Needle examination is a study that is often used for the treatment of MP and
does not form an additional risk for the patient group. Often described adverse
effects for both groups are haematoma, reversible dermatomal change or duration
of pain after injection. Furthermore a temporary increase in numbness in the
area of the LFCN can occur.