Femoral neuropathy

Ryan Jacobson MD (Dr. Jacobson of Loyola University Chicago Stritch School of Medicine has no relevant financial relationships to disclose.)
Randolph W Evans MD, editor. (Dr. Evans received honorariums from Allergan, Amgen, Avanir, DepoMed, and Novartis for speaking engagements and honorariums from Alder, Amgen, Lilly, Novartis, and Promius for advisory board membership.)
Originally released November 21, 1997; last updated January 31, 2018; expires January 31, 2021

This article includes discussion of femoral neuropathy, femoral mononeuropathy, and femoral nerve injury. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Key points

 

• Femoral neuropathy presents, often acutely, with thigh weakness, numbness, and variable pain. Hip flexion weakness is observed in more proximal lesions.

 

• Examination typically reveals weakness of knee extension with absent or depressed knee jerk and normal thigh adduction.

 

• Most femoral neuropathies are caused by iatrogenic compression of the nerve either in the pelvis or beneath the inguinal ligament.

 

• Isolated femoral neuropathy in diabetics is an extremely rare occurrence.

 

• Nerve conduction studies and needle EMG are useful for diagnostic and prognostic purposes.

Historical note and terminology

Early published literature led many to believe that diabetes mellitus is associated with selective femoral neuropathy. It is now clear that isolated femoral neuropathy in diabetics is rare, and most reported cases were mislabeled, actually having diabetic amyotrophy or radiculoplexopathy. Diabetic amyotrophy has become more widely recognized and, therefore, both clinically and electrophysiologically, no reliable reports of isolated diabetic femoral neuropathy have been published during the last 3 decades.

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