• Annals of Clinical Neurophysiology
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• 제15권2호
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• pp.48-52
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• 2013

Background: Meralgia paresthetica (MP) is a mononeuropathy affecting the lateral femoral cutaneous nerve. The disease is often diagnosed clinically, but electrophysiological tests play an important role. The aim of this study is to clarify clinical characteristics of MP as well as the role of sensory nerve conduction study (NCS) in the diagnosis of MP. Methods: Sixty-five consecutive patients with clinical diagnosis of MP between March 2001 and June 2012 were retrospectively reviewed at a single tertiary center. General demographics, clinical characteristics and sensory NCS findings were investigated. Measurements of sensory NCS included the baseline-to-peak amplitude, side-to-side amplitude ratio and the conduction velocity. To compare between the normal and abnormal NCS groups, independent t-tests and chisquare test were performed. Results: Sixty-five patients had male predominance (56.9%) with mean age of $48.4{\pm}13.4$ years (range: 16-75). Seven patients (13.5%) had undergone operation or procedure before the symptom onset. The sensory nerve action potentials were obtainable in 52 (80%) of 65 clinically diagnosed MP patients. Sensory NCS revealed abnormalities in 38 patients (73.1%), and others (n=14, 26.9%) showed normal findings. Between the normal and abnormal NCS groups, there is no statistically significant difference on demographics or clinical features. Conclusions: We clarify the clinical features and sensory NCS findings of MP patients. Due to several limitations of sensory NCS, the diagnosis of MP could be accomplished both clinically and electrophysiologically.

• Journal of Yeungnam Medical Science
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• 제18권1호
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• pp.67-74
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• 2001

정상 성인 남녀 36명(남:여=23:13)을 대상으로 LFCN의 SSEP검사를 시행한 결과로서 다음과 같은 결론을 얻을 수 있었다. 1. MP의 진단에 있어서는 $P_0$, $N_1$의 절대잠복기 뿐만 아니라 좌 우측 잠복기의 차이값($DP_0$, $DN_1$을 비교하여 보는 것이 더욱 중요하며 그 차이는 모두 2 msec 이하였다. 2. $P_0N_1$의 진폭만으로 비정상과 정상의 기준을 정할 수는 없으나 좌 우측 평균 진폭의 차이는 1.6배 이하였다. 3. $P_0(N_1)$, $DP_0(DN_1)$, 그리고 A(DA)에 있어 남녀군 간의 차이는 없었다.

• 대한약침학회지
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• 제12권2호
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• pp.21-29
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• 2009

Objective : This study was carried to identify the anatomical component of FTMM(Foot Taeyang Meridian Muscle) in human lower limb, and further to help the accurate application to real acupuncture. Methods : FTM at the surface of the lower limb was labelled with latex. And cadaver was stripped off to demonstrate muscles, nerves and the others and to display the internal structures of FTMM, being divided into outer, middle, and inner layer. Results : FTMM in human lower limb is composed of muscles, nerves, ligaments etc. The internal composition of the FTMM in human lower limb are as follows : 1) Muscle : Gluteus maximus. biceps femoris, semitendinosus, gastrocnemius, triceps calf, fibularis brevis tendon, superior peroneal retinacula, calcaneofibular ligament, inferior extensor retinaculum, abductor digiti minimi, sheath of flexor tendon at outer layer, biceps femoris, semimembranosus, plantaris, soleus, posterior tibialis, fibularis brevis, extensor digitorum brevis, flexor digiti minimi at middle layer, and for the last time semimembranosus, adductor magnus, plantaris, popliteus, posterior tibialis, flexor hallucis longus, dorsal calcaneocuboidal ligament at inner layer. 2) Nerve : Inferior cluneal nerve, posterior femoral cutaneous n., sural cutaneous n., proper plantar branch of lateral plantar n. at outer layer, sciatic nerve, common peroneal n., medial sural cutaneous n., tibial n. at middle layer, and for the last time tibial nerve, flexor hallucis longus branch of tibial n. at inner layer. Conclusions : This study proves comparative differences from already established studies from the viewpoint of constituent elements of FTMM in the lower limb, and also in the aspect of substantial assay method. We can guess that there are conceptional differences between terms (that is, nerves which control muscles of FTMM and those which pass near by FTMM) in human anatomy.

• Archives of Reconstructive Microsurgery
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• 제6권1호
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• pp.103-110
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• 1997

Since R.Y. Song(1982) has reported anatomic studies about septocutaneous perforator flap, various experiences especially on thigh flaps pedicled on septocutaneous artery were reported. Baek(1983) reported an anatomic study through the cadavers dissections on medial, lateral thigh area and provided the first new cutaneous free flap of thigh for clinical use. Song, et a1.(1984) reported anterolateral thigh free flap, Koshima, et al.(1989) reported pedicle variations and its versatile clinical usages. According to their reports, accessory branches of lateral femoral circumflex artery are placed in comparatively constant location and proved to be the effective pedicle of this flap. The advantages of anterolateral thigh free flap are 1) comparatively thin 2) can obtain sufficiently large flap 3) can contain cutaneous nerve 4) can be easy to approach anatomically because pedicle is located in comparatively constant position 5) minimal donor site morbidity. We report the experience of 10 cases of anterolateral thigh free flap coverage for soft tissue defects: 4 cases of soft tissue defects on foot area, 2 cases of soft tissue defects on hand, 3 cases of partial tongue defects owing to tongue cancer ablation, and 1 case of soft tissue defect on nasal alar.

• Journal of Acupuncture Research
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• 제22권1호
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• pp.109-115
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• 2005

대퇴부 작열감, 동통, 부종을 주소로 내원한 환자 1례를 대상으로 점액낭염에 의한 meralgia paresthetica의 진단 하에 한방적 치료를 시행하여 임상 양상을 관찰한 결과 다음과 같은 결론 을 얻었다. 1. meralgia paresthetica는 포착성 신경병증으로 외측 대퇴 피 신경이 압박되거나 손상되어, 대퇴부 전외측에 감각 저하, 이상 감각 및 작 열감을 호소하는 질환이다. 2. meralgia paresthetica는 한방적으로 '비병(痺病)', '마목(麻木)' 등의 범주에 해당하며 양혈산한통락(養血散寒通絡)의 치법을 활용할 수 있다. 3. 통비(痛痺)와 착휘(着輝)에 해당하는 meralgia paresthetica환자에게 가미활혈탕(加味活血湯) 투여 및 환측(患側)의비관(?關) 복토(伏兎) 충문(衝門) 풍시(風市) 족삼리(足三里) 등의(等) 혈위(穴位)에 자침(刺針)과 습식부항(濕式附缸)을 시술하여 6일만에 현저한 치료 효과를 보았다. 4. 환자는 고관절의 ROM에 있어서 초진시 신전제한 $60^{\circ}$였으나, 5회의 치료 후 신전제한 $0^{\circ}$로 회복되었으며 퇴원시 대퇴부 인통(引痛), 부종(浮腫), 발열(發熱) 등의 증상이 모두 경감되었다.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.363-366
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• 2012

Objective : Meralgia paresthetica (MP) is a syndrome of pain and/or dysesthesia in the anterolateral thigh that is caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at its pelvic exit. Despite early accounts of MP, there is still no consensus concerning the effectiveness of neurolysis or transaction treatments in the long-term relief for medically refractory patients with MP. We retrospectively analyzed available long-term results of LFCN neurolysis for medically refractory MP in an effort to clarify this issue. Methods : During the last 7 years, 11 patients who had neurolysis for MP were enrolled in this study. Nerve entrapment was confirmed preoperatively by electrophysiological studies or a positive response to local anesthetic injection. Decompression of the LFCN was performed at the level of the iliac fascia, inguinal ligament, and fascia of the thigh distally. The outcome of surgery was assessed 8 weeks after the procedure followed at regular intervals if symptoms persisted. Results : Twelve decompression procedures were performed in 11 patients over a 7-year period. The average duration of symptoms was 8.5 months (range, 4-15 months). The average follow-up period was 33 months (range, 12-60 months). Complete and partial symptom improvement were noted in nine (81.8%) and two (18.2%) cases, respectively. No recurrence was reported. Conclusion : Neurolysis of the LFCN can provide adequate pain relief with minimal complications for medically refractory MP. To achieve a good outcome in neurolysis for MP, an accurate diagnosis with careful examination and repeated blocks of the LFCN, along with electrodiagnosis seems to be essential. Possible variation in the course of the LFCN and thorough decompression along the course of the LFCN should be kept in mind in planning decompression surgery for MP.

• 한방재활의학과학회지
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• 제32권3호
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• pp.171-178
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• 2022

Meralgia paresthetica is a rare femoral disease and various symptoms appear such as pain, numbness, and paresthesia in the anterolateral thigh due to entrapment of the lateral femoral cutaneous nerve. We treated the meralgia paresthetica patients with Korean medicine treatment including herbal medicine, acupuncture, Chuna manual therapy and pharmacopuncture during 12 days. Numerical rating scale (NRS), Euroqol five dimension (EQ-5D) index, and the changes of symptoms were measured for assessment. After 12 days inpatient treatment, NRS decreased from 7 to 4, EQ-5D index and the symptoms of the patient also were improved. In conclusion, this case shows Korean medicine treatment might be an effective treatment for Meralgia paresthetica.

• 대한한의학회지
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• 제32권3호
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• pp.1-9
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• 2011

Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

• Anatomy and Cell Biology
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• 제57권1호
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• pp.143-146
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• 2024

The current cadaveric report describes an unusual morphology of the sartorius muscle (SM), the biceps-bicaudatus variant. The SM had two (lateral and medial) heads, with distinct tendinous origins from the anterior superior iliac spine. The lateral head was further split into a lateral and a medial bundle. The anterior cutaneous branch of the femoral nerve emerged between the origins of the lateral and medial heads. SM morphological variants are exceedingly uncommon, with only a few documented cases in the literature, and several terms used for their description. Although their rare occurrence, they may play an important role in the differential diagnosis of entrapment syndromes, in cases of neural compressions, such as meralgia paresthetica, while careful dissection during the superficial inter-nervous plane of the direct anterior hip approach is of utmost importance, to avoid adverse effects due to the altered SM morphology.

• Korean Journal of Acupuncture
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• 제33권2호
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• pp.89-93
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• 2016

Objectives : The purpose of this case is to report the improvement after treatment about a patient with meralgia paresthetica. Methods : We treated the patient with acupucture therapy, cupping therapy, electroacupuncture therapy, percutaneous radiofrequency thermoablation and myofascial release technique by Turbo SASO from $26^{th}$ June 2015 to $3^{rd}$ July 2015 by evaluating femoral function with VAS score. Results : After 5 times of treatment, this patient achieved excellent outcome following the technique, showing that clinical symptom as able to walked and pain was disappeared, VAS changed from 10 to 3 and the result of patrick test came out negative. Conclusions : The various symptoms appear in the Meralgia paresthetica such as numbness, paresthesia, and pain in the anterolateral thigh, which may result from either an entrapment neuropathy or a neuroma of the lateral femoral cutaneous nerve(LFCN). Oriental medical treatment for meralgia paresthetica resulted in satisfactory results by diminishing the symptoms progressively during the five days of treatment. Differential diagnosis was based on careful physical examination. More research of meralgia paresthetica is needed.