Bernhardt-Roth syndrome
definition
The Bernhardt-Roth syndrome, also called Meralgia paraesthetica (Greek: mêros = thigh, algos = pain, paraesthetica = unpleasant, sometimes painful physical sensation), is a Nerve congestion syndrome of Lateral femoral cutaneous nerve. This nerve runs through the Inguinal ligament through and leads Touch sensations the outside of the Thigh to the Spinal cord further. By constricting the nerve, its pathway is disturbed, leading to Paresthesia and Pain in the area supplied by the nerve. Nerve congestion syndromes also include, for example, the more commonly known one Carpal tunnel syndrome.
Symptoms
The Bernhardt-Roth syndrome manifests itself through abnormal sensations up to burning, tingling, pinprick pain on the front and side thighs. Since it is damage to a purely sensitive nerve acts are exclusive Emotional sensations, e.g. from the skin. Muscle movements are not impaired.
This nerve damage can also lead to one in the course of the disease generally increased sensitivity (Hyperesthesia), which even make wearing clothes or light touch unbearable.
Furthermore, a decreased sensitivity (Hypesthesia) - the area of the leg feels numb or furry - arising from it. It is characteristic that the symptoms are Hip flexion (for example while sitting) soothes. If the impairment is very severe vegetative disorders, such as Hair loss or Skin changes, possible. The vegetative (autonomous) nervous system controls the unconscious physical processes that are not intentionally influenced.10 to 20 percent of patients are bilateral and men are up to three times more likely to suffer from Berhardt-Roth syndrome than women.
causes
The Bernhardt-Roth syndrome is mainly caused by pressure on the lateral femoral cutaneous nerve in the area of the Inguinal ligament evoked. Here the nerve is particularly endangered, as the course runs from an initially horizontal to a vertical direction and thus a Kink arises.
Another possibility are Tensile forcesthat act on the nerve. Also a complication from surgical procedures such as a Puncture of the iliac crest for the removal of Bone marrow and rarely after complicated ones Abdominal surgery or Hip joint surgery should be considered as the cause of Bernhardt-Roth syndrome.
Furthermore, in general Infections (e.g. syphilis) or alcoholism and other Neurotoxins to Nerve damage to lead. An increased pressure on the nerves can result tight clothes (Jeans, belt), through Obesity (Obesity), pregnancy, forced strength training in the area of Thigh, of the hip and the belly or also long standing activity arise with a very extended hip joint. But also one rapid weight loss can lead to the above-mentioned complaints, as the surrounding connective tissue and fat disappears and this can lead to irritation.
diagnosis
The basis of the diagnosis of Bernhardt-Roth syndrome is a comprehensive medical questioning (anamnesis), physical and neurological examination. This is especially the case decreased sensation in the field of lateral outer thigh. At Hyperextension of the hip joint with the leg extended, pain in the supply area of the pinched nerve is provoked. Also is the place where the nerve is under the Inguinal ligament runs through it more pressure painful. This place is about two cross fingers medial (i.e. towards the middle of the body) of the upper one Iliac crest protrusion.
Through a MRI (Magnetic resonance imaging) can change anatomical conditions or tumorous masses be assessed. By injecting a local anesthetic (Local anesthetic) on the inguinal ligament and a subsequent improvement in symptoms can substantiate the suspicion of Bernhardt-Roth syndrome.
A suspicion of Root compression syndrome, i.e. a mechanical irritation of a nerve in the area of the Spine, where the nerves emerge from the spinal cord, should be excluded in the diagnosis. In contrast to Bernhardt-Roth syndrome, here are often Muscle paralysis, Reflex weakening certain characteristic muscles of the leg (e.g. the patellar tendon reflex - reflex of the anterior large thigh muscle) and abnormal sensations in other skin areas of the thigh and lower leg are noticeable.
therapy
First of all, a Educating the patient about the Harmlessness of his complaints. As the main trigger of Bernhardt-Roth syndrome Obesity or clothing that is too tight the weight should be through first Diet change and increased endurance sports be normalized. After all, the main causes of obesity are poor diet and too little physical activity. Among other things, it makes sense to refrain from consuming meat every day. In addition, fat should be consumed in as small amounts as possible and an increased proportion of vegetables and fruit should be consumed instead. A comprehensive Nutritional advice however, should be claimed.
In addition, should be on casual clothing (especially in the area of the inguinal ligament and the thigh). Avoiding long standing in a stretched position is beneficial. Common pain relievers like Ibuprofen often lead to a relief of the symptoms. If the pain does not improve as a result, a special pain therapy with a Cortisone preparation or one Nerve block with a local narcotics respectively.
OP
If the symptoms are very severe and persistent, neurolysis (OP of the nerve) can be carried out.
Read our topic: OP a meralgia paraesthetica
forecast
The prognosis for Bernhardt-Roth syndrome is comparatively good, as the treatment relieves symptoms in nine out of ten patients. The causes can usually be eliminated easily (for example, clothing that is too tight). There is also a spontaneous regression of the abnormal sensations in every fourth patient, so that the symptoms disappear by themselves.
