Case History
A 54 year-old female (BMI 24.0) with a history of migraines and
depression presented with four months of burning pain and numbness in
her right lateral thigh. She described how her 9 out of 10 pain began
immediately following right subacromial decompression in 2003. Nerve
conduction studies revealed absent sensory nerve action potential (SNAP)
in the right lateral femoral cutaneous nerve compared to the left. Her
surgeon attributed the lateral femoral cutaneous nerve mononeuropathy
secondary to intraoperative seat belt tightness. She was initially
diagnosed with meralgia paresthetica and treated with gabapentin.
Despite treatment, her symptoms persisted and were accompanied by
allodynia, temperature fluctuations, skin discoloration, asymmetrical
sweating, weakness, and trophic changes. This constellation of symptoms
ultimately led to a diagnosis of CRPS in 2010.
Of note, the patient began experiencing glossodynia in 2009, with
attacks occurring about four times per week and lasting from 2 hours to
3 days. The pain was rated at 8 to 10 out of 10 and was not responsive
to medical management.