Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Femoral Mononeuropathy Clinical Presentation

  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
 
Updated: Mar 24, 2016
 

History

Patients with femoral neuropathy complain of difficulty with stairs and frequent falling secondary to "knee buckling." This weakness is typically of acute or subacute onset. On occasion a femoral neuropathy can be associated with an athletic injury.[14] This contrasts with a myopathic process in which the weakness is subacute to chronic in onset and bilateral in nature.

Acute, severe pain in the groin, thigh, and/or lower abdomen may occur if the neuropathy is associated with a retroperitoneal hematoma.[15] Otherwise, the associated pain is usually mild and located near the inguinal ligament.

Patients may complain of medial leg and calf numbness. Sensory symptoms in saphenous nerve distribution are rare with injury to the main trunk of the femoral nerve.

Next

Physical Examination

Weakness of the quadriceps muscle and decreased patellar reflex are the most striking examination findings. If the neuropathy is advanced and chronic, wasting of the quadriceps may be noted. If a retroperitoneal hematoma is present, hip extension may cause pain.

In some patients, the iliopsoas muscle is involved. In such cases, the lesion must be above the inguinal ligament, as the motor branch to this muscle comes off before the inguinal ligament.

In isolated femoral neuropathies, the thigh adductors are normal. Although the thigh adductors share common lumbar roots with the muscles innervated by the femoral nerve, they are innervated by the obturator nerve along with the sciatic nerve and therefore are spared. Sensory deficits consist of numbness of the medial thigh and the anteromedial calf.

Previous
 
 
Contributor Information and Disclosures
Author

Wayne E Anderson, DO, FAHS, FAAN Assistant Professor of Internal Medicine/Neurology, College of Osteopathic Medicine of the Pacific Western University of Health Sciences; Clinical Faculty in Family Medicine, Touro University College of Osteopathic Medicine; Clinical Instructor, Departments of Neurology and Pain Management, California Pacific Medical Center

Wayne E Anderson, DO, FAHS, FAAN is a member of the following medical societies: California Medical Association, American Headache Society, San Francisco Medical Society, San Francisco Medical Society, International Headache Society, California Neurology Society, San Francisco Neurological Society, American Academy of Neurology, California Medical Association

Disclosure: Received honoraria from Teva for speaking and teaching; Received grant/research funds from Allergan for other; Received honoraria from Insys for speaking and teaching; Received honoraria from DepoMed for speaking and teaching.

Chief Editor

Nicholas Lorenzo, MD, MHA, CPE Founding Editor-in-Chief, eMedicine Neurology; Founder and CEO/CMO, PHLT Consultants; Chief Medical Officer, MeMD Inc

Nicholas Lorenzo, MD, MHA, CPE is a member of the following medical societies: Alpha Omega Alpha, American Association for Physician Leadership, American Academy of Neurology

Disclosure: Nothing to disclose.

Acknowledgements

Neil A Busis, MD Chief, Division of Neurology, Department of Medicine, Head, Clinical Neurophysiology Laboratory, University of Pittsburgh Medical Center-Shadyside

Neil A Busis, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Elizabeth A Sekul , MD Associate Professor of Pediatrics and Neurology, Medical College of Georgia

Elizabeth A Sekul, MD is a member of the following medical societies: American Academy of Neurology; American Association of Neuromuscular and Electrodiagnostic Medicine; and Child Neurology Society

Disclosure: Nothing to disclose.

Aashit K Shah, MD Associate Professor of Neurology, Wayne State University; Program Director, Clinical Neurophysiology Fellowship, Department of Neurology, Detroit Medical Center

Aashit K Shah, MD is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, and American Epilepsy Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

References
  1. Phang IS, Biant LC, Jones TS. Neurostenalgia of the femoral nerve: a treatable cause of intractable hip pain in a young adult. J Arthroplasty. 2010 Apr. 25(3):498.e15-7. [Medline].

  2. Olesen LL. Femoral neuropathy secondary to anticoagulation. J Intern Med. 1989 Oct. 226(4):279-80. [Medline].

  3. Colak M, Canbaz H, Ayan I, Karabacak T, Kuyurtar F. Intrapelvic mass causing femoral compression neuropathy in a patient with Gaucher disease: a case report. Eklem Hastalik Cerrahisi. 2009. 20(3):169-73. [Medline].

  4. al Hakim M, Katirji B. Femoral mononeuropathy induced by the lithotomy position: a report of 5 cases with a review of literature. Muscle Nerve. 1993 Sep. 16(9):891-5. [Medline].

  5. Peirce C, O'Brien C, O'Herlihy C. Postpartum femoral neuropathy following spontaneous vaginal delivery. J Obstet Gynaecol. 2010 Feb. 30(2):203-4. [Medline].

  6. Wong CA. Nerve injuries after neuraxial anaesthesia and their medicolegal implications. Best Pract Res Clin Obstet Gynaecol. 2010 Jan 4. [Medline].

  7. Kurt S, Kaplan Y, Karaer H, Erkorkmaz U. Femoral nerve involvement in diabetics. Eur J Neurol. 2009 Mar. 16(3):375-9. [Medline].

  8. Krendel DA, Zacharias A, Younger DS. Autoimmune diabetic neuropathy. Neurol Clin. 1997 Nov. 15(4):959-71. [Medline].

  9. Llewelyn JG, Thomas PK, King RH. Epineurial microvasculitis in proximal diabetic neuropathy. J Neurol. 1998 Mar. 245(3):159-65. [Medline].

  10. Collins MP, Periquet-Collins I. Nonsystemic vasculitic neuropathy: update on diagnosis, classification, pathogenesis, and treatment. Front Neurol Neurosci. 2009. 26:26-66. [Medline].

  11. Naroji S, Belin LJ, Maltenfort MG, Vaccaro AR, Schwartz D, Harrop JS, et al. Vulnerability of the femoral nerve during complex anterior and posterior spinal surgery. J Spinal Cord Med. 2009. 32(4):432-5. [Medline]. [Full Text].

  12. Azuelos A, Coro L, Alexandre A. Femoral nerve entrapment. Acta Neurochir Suppl. 2005. 92:61-2. [Medline].

  13. Farrell CM, Springer BD, Haidukewych GJ, Morrey BF. Motor nerve palsy following primary total hip arthroplasty. J Bone Joint Surg Am. 2005 Dec. 87(12):2619-25. [Medline].

  14. Meadows JR, Finnoff JT. Lower extremity nerve entrapments in athletes. Curr Sports Med Rep. 2014 Sep-Oct. 13 (5):299-306. [Medline].

  15. Parmer SS, Carpenter JP, Fairman RM, Velazquez OC, Mitchell ME. Femoral neuropathy following retroperitoneal hemorrhage: case series and review of the literature. Ann Vasc Surg. 2006 Jul. 20(4):536-40. [Medline].

Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.