Disclosures: Andrés E. Gutiérrez Robles, MD: No financial relationships or conflicts of interest

Case Diagnosis: Meralgia Paresthetica

Case Description: 38 y/o M with a history of Crohn’s and obesity that began after he was admitted to the intensive care unit (ICU) for adrenal crisis after sudden discontinuation of steroids. Following discharge from the ICU patient gained two hundred pounds and developed bilateral lower extremity pain and paresthesias. He described his pain as burning-like on the anterolateral aspect of left > right thighs. His pain and functional status worsened to the point where he was only able to ambulate household distances. He was diagnosed with meralgia paresthetica (MP) based on clinical symptoms and nerve conduction study. He was referred to our outpatient clinic for bilateral lateral femoral cutaneous nerve blocks. Prior to the referral, he was started on opioids and neuropathic agents with limited pain relief. Patient underwent two lateral femoral cutaneous nerve blocks with limited duration of efficacy and pain relief. After discussing multiple interventional options, we ultimately proceeded with spinal cord stimulator (SCS) trial. Patient had tremendous relief during the trial where patient was ambulatory and was more functional with his activities of daily living. Given the success of the trial we proceeded with spinal cord stimulator implantation.

Setting: Outpatient ClinicAssessment/

Results: After a successful SCS trial with 70% reduction in his pain, we proceeded with SCS implantation . At the 2 month follow-up visit since the implant, patient continues to report resolution of his pain and improvenemt in regards to his overall functional status.

Discussion: MP is typically benign and self-limiting, although recurrence is common. If persistent, MP is traditionally managed with pharmaceutical agents or surgical decompression. However, surgical decompression for MP does not guarantee resolution of symptoms. We propose the use of SCS for patients with MP as an alternative option.

Conclusion: SCS is a therapeutic modality that could be used to treat patients with chronic refractive MP.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/utilization-of-spinal-cord-stimulation-in-a-patient-with-bilateral-meralgia-paresthetica/