-Case Reports-

Meralgia Paresthetica Caused by Surgery in the Park-Bench Position

Rinko Kokubo¹, Kyongsong Kim¹, Katsuya Umeoka¹, Toyohiko Isu² and Akio Morita³

¹Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
²Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan
³Department of Neurosurgery, Nippon Medical School, Tokyo, Japan

Objective: Meralgia paresthetica (MP) is an entrapment neuropathy of the lateral femoral cutaneous nerve (LFCN). We report a rare case of MP after microvascular decompression (MVD) surgery in the park-bench position in a patient with hemifacial spasm.
Case: The patient was a nondiabetic 46-year-old woman (height: 155 cm, weight: 42 kg) who consumed alcohol infrequently. After a first MVD for right hemifacial spasm, the symptom recurred and she underwent a second MVD procedure in the park-bench position, after which hemifacial spasm resolved. However, she reported right anterolateral thigh pain and dysesthesia without motor weakness. The pain was limited to the LFCN area, and a pelvic compression test elicited a positive Tinel-like sign. Our preliminary diagnosis was MP. Because conservative therapy was ineffective, she underwent LFCN block 9 months after the second MVD procedure. Her pain improved dramatically and we made a definitive diagnosis of MP. There has been no recurrence after 30 months of observation, although she reported persistent mild dysesthesia in the LFCN area.
Conclusion: MP is a rare complication after MVD surgery in the park-bench position. LFCN block can resolve symptoms and hasten diagnosis.

J Nippon Med Sch 2022; 89: 355-357

Keywords
lateral femoral cutaneous nerve, park-bench position

Correspondence to
Rinko Kokubo, MD, PhD, Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
rin-ko927@nms.ac.jp

Received, December 19, 2020
Accepted, February 3, 2021