eMedicine Specialties > Neurology > Electromyography and Nerve Conduction Studies

Femoral Mononeuropathy: Differential Diagnoses & Workup

Author: Elizabeth A Sekul, MD, Department of Neurology, Associate Professor, Medical College of Georgia
Contributor Information and Disclosures

Updated: Mar 20, 2007

Differential Diagnoses

Vasculitic Neuropathy

Other Problems to Be Considered

Lumbar plexopathies
Lumbosacral disk syndromes

Workup

Imaging Studies

  • In cases of suspected retroperitoneal hematoma, an emergent CT scan of the pelvis should be performed.
  • In other cases in which the etiology is not apparent, MRI or CT scan of the pelvis may be beneficial to aid in localizing the site of compression and may define the etiology (eg, tumor, abdominal aneurysm, iliac aneurysm).

Other Tests

  • Evaluation for femoral nerve dysfunction includes nerve conduction studies (NCS) and needle electromyography (EMG).
  • NCS should include sensory studies of the saphenous nerve and motor studies of the femoral nerve.
  • When evaluating femoral NCS, results on the symptomatic side should be compared to those on the asymptomatic side.
  • On EMG, the quadriceps should show neuropathic changes.
  • The iliopsoas is involved if the lesion is in the pelvis (above the inguinal ligament).
  • The adductor magnus and brevis, which share lumbar innervation with quadriceps and iliopsoas, are spared since they are innervated primarily by the obturator and sciatic nerves.

More on Femoral Mononeuropathy

Overview: Femoral Mononeuropathy
Differential Diagnoses & Workup: Femoral Mononeuropathy
Treatment & Medication: Femoral Mononeuropathy
References
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References

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

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

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

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

  5. Williams FH, Johns JS, Weiss JM. Neuromuscular rehabilitation and electrodiagnosis. 1. Mononeuropathy. Arch Phys Med Rehabil. Mar 2005;86(3 Suppl 1):S3-10. [Medline].

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

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Further Reading

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Keywords

femoral nerve, nerve entrapment, nerve compression, femoral nerve anatomy, knee buckling

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Contributor Information and Disclosures

Author

Elizabeth A Sekul, MD, Department of Neurology, Associate Professor, 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.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Neil A Busis, MD, Chief, Division of Neurology, Department of Medicine, University of Pittsburgh Medical Center - Shadyside, Clinical Associate Professor, Department of Neurology, University of Pittsburgh School of Medicine
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.

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Y Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Y Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
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