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Intervention Review

Treatment for meralgia paraesthetica

  1. Nofal Khalil1,*,
  2. Alessia Nicotra2,
  3. Wojtek Rakowicz2

Editorial Group: Cochrane Neuromuscular Disease Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 4 OCT 2010

DOI: 10.1002/14651858.CD004159.pub2

How to Cite

Khalil N, Nicotra A, Rakowicz W. Treatment for meralgia paraesthetica. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD004159. DOI: 10.1002/14651858.CD004159.pub2.

Author Information

  1. 1

    West London Neurosciences Centre, Clinical Neurophysiology, London, UK

  2. 2

    Charing Cross Hospital, West London Neurosciences Centre, London, UK

*Nofal Khalil, Clinical Neurophysiology, West London Neurosciences Centre, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK. nofal.khalil@imperial.nhs.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 16 JUL 2008

SEARCH

This is not the most recent version of the article. View current version (12 DEC 2012)

 

Abstract

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  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Meralgia paraesthetica is a clinical syndrome for which a number of treatments are in common use, including conservative measures, injection of corticosteroid with local anaesthetic and surgery. We aimed to examine the evidence for the relative efficacy of these interventions. This is an updated review. An updated search was undertaken in which no new studies were found.

Objectives

To assess the relative efficacy of commonly used treatments.

Search methods

We searched the Cochrane Neuromuscular Disease Group Specialized Register (5 October 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (11 October 2010, issue 4, 2010 in The Cochrane Library), MEDLINE (January 1966 to September 2010), EMBASE (January 1980 to September 2010) and CINAHL Plus (January 1937 to September 2010) for randomised controlled studies. Non-randomised studies were identified by searching MEDLINE (January 1966 to September 2010) and EMBASE (January 1980 to September 2010). We also inspected the reference lists of these studies.

Selection criteria

We were unable to identify any randomised controlled or quasi-randomised controlled trials. We therefore looked for high quality observational studies meeting the following criteria:
(1) At least five cases of meralgia paraesthetica.
(2) Follow-up of at least three months after intervention (if any).
(3) At least 80% of cases followed up.

Data collection and analysis

Three authors independently extracted relevant data from each study meeting the selection criteria and transferred into a data extraction form.

Main results

We found no randomised controlled or quasi-controlled trials. Cure or improvement have been described in high quality observational studies:
(1) A single study describes spontaneous improvement of meralgia paraesthetica in 20 (69%) of 29 cases.
(2) Four studies evaluating the injection of corticosteroid and local anaesthetic found cure or improvement in 130 (83%) out of a combined total of 157 cases.
(3) Surgical treatments have been found to be beneficial in 264 (88%) out of 300 cases treated with decompression (nine studies); and 45 (94%) out of 48 cases treated with neurectomy (three studies).
(4) Ninety-nine (97%) out of 102 patients with iatrogenic meralgia paraesthetica recovered completely (three studies).

Authors' conclusions

In the absence of any published randomised controlled or quasi-randomised controlled trials, the objective evidence base for treatment choices in meralgia paraesthetica is weak. High quality observational studies report comparable high improvement rates for meralgia paraesthetica following local injection of corticosteroid and surgical interventions (either nerve decompression or neurectomy). However, a similar outcome has been reported without any intervention in a single natural history study.

 

Plain language summary

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  2. Abstract
  3. Plain language summary
  4. 摘要

Treatment for meralgia paraesthetica, a condition causing numbness and sometimes pain in the thigh

Meralgia paraesthetica is a common clinical condition caused by damage to the lateral cutaneous nerve of the thigh, resulting in pain, numbness and tingling in the front and outer side of the thigh. The diagnosis is easy to make clinically. Although not life-threatening, the condition can cause a lot of discomfort to the affected individual. A number of interventions are in common use and we wanted to examine the evidence in the literature for their efficacy. No randomised controlled trials were found. Local injections of corticosteroid and surgical operations were found to be effective treatments in observational studies. However, a single observational study also showed that meralgia paraesthetica improved spontaneously in the majority of cases. Randomised controlled trials of treatments for meralgia paraesthetica are needed. This is an updated review. An updated search was undertaken in which no new studies were found.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

異常性股麻痛(meralgia paraesthetica)的治療

異常性股麻痛是一種臨床症候群,對於這種疾病的治療包含有注射局部麻醉劑和類固醇以及手術。此篇研究的目的在於驗證這些治療方式的成效。

目標

評估異常性股麻痛治療的成效

搜尋策略

搜尋的範圍包括:Cochrane Neuromuscular Disease Group Trials Register (April 2008), MEDLINE (January 11966 to April 18 2008), EMBASE (January 1 1980 to May 12 2008) and CINAHL(January 1 1980 to May 12 2008) for randomised controlled studies. Nonrandomised studies were identified by searching MEDLINE (January 1 1966 to April 18 2008) and EMBASE (January 1 1980 to May 12 2008). 包含這些研究以及研究論文本身所附加的參考文章。

選擇標準

因為沒有搜尋到隨機試驗,於是若符合: 1. 至少五個病患2. 觀察期至少三個月,3.最後完成研究的人數超過一開始的80%, 上述三個條件都符合的高品質的觀察性研究可納入分析。

資料收集與分析

由三個不同的作者獨立地由符合條件的研究選取資料,再轉換成統一格式進行分析。

主要結論

我們並沒有搜尋到任何隨機控制試驗。僅找到幾個高品質的觀察性研究有報告能夠治癒或是能改善病況的治療,包括(1)有一個研究提到29個病患中有20個人(69%)出現自發性的好轉。(2)四個研究評估注射類固醇和局部麻醉劑的功效,總共157個病人中,130人(83%)痊癒或是有臨床進步。(3)手術治療部分,其中進行減壓手術(decompression)的九個研究300個病人中,有264個病人(88%)臨床進步,而施以神經切斷術(neurectomy)的三個研究48個病人中,有45位(94%)得到進步。(4)醫源性異常性股麻痛的三個研究102個病人中,99個病人(97%)能夠完全恢復。

作者結論

因為沒有隨機控制試驗的支持,對於異常性股麻痛的治療選擇缺乏足夠的證據。由一些高品質的觀察性研究結果看來,不管是進行手術或是局部類固醇及麻醉劑的注射都有蠻高的改善率。但是,在一個觀察異常性股麻痛自然病程的研究中也發現,沒有接受任何治療病患也有相近的改善率。

翻譯人

本摘要由新光醫院王瑄翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

異常性股麻痛的治療方式:異常性股麻痛是外側股皮神經的損害造成大腿外側和前側的麻痛。診斷可以根據臨床症狀來推斷。雖然並不威脅生命,但仍造成病患很大的不適。我們想要評估一些臨床上常用治療的實際成效。搜尋過去的研究並沒有相關的隨機控制試驗研究,但在觀察性研究中,注射類固醇和手術治療都被提出是有效的治療方式。但是,在一篇研究中也發現,異常性股麻痛的病人在未經治療的情況下,大部分的病人會自動好轉。對於異常性股麻痛的治療需要更進一步的隨機對照試驗。