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Femoral Mononeuropathy Treatment & Management

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

Approach Considerations

Treatment is dependent on the etiology of the lesion. As previously stated, most patients with a femoral mononeuropathy can be treated conservatively with physical therapy, avoidance of excessive hip abduction and external rotation, and knee bracing to prevent buckling of the knee. In cases of painful femoral neuropathy, neuropathic pain medications may provide benefit.

In patients with femoral neuropathy associated with positional compression or retraction compression during surgery or delivery, recovery typically occurs over 3-4 months.

When the cause of the neuropathy is a retroperitoneal hematoma, evacuation of the hematoma may be indicated, but this is controversial.[15] In patients on anticoagulation therapy, anticoagulant agents must be stopped until the hematoma has resolved. Outcomes for these patients are worse than for those with a hematoma due to trauma.

If the compression is due to a tumor, then therapy, either surgery or chemotherapy, is directed at the neoplasm. When the neuropathy is due to diabetes or vasculitic causes, immunosuppressive therapy may be warranted.[10]

Surgical decompression

Surgical decompression of the nerve sometimes is performed for neuropathies resulting from hematomas or mass lesions. Femoral decompression is indicated in cases of intractable pain associated with femoral nerve compression.[1] Occasionally, surgical exploration for other reasons (eg, penetrating wounds, fascia bands) is indicated.

Consultations

Consultation with an electrodiagnostic laboratory (EMG/nerve conduction velocity [NCV] studies) may help to determine the location, severity, and potential permanency of the lesion.

 
 
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
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