Femoral neuropathy

Sameera Salman Ghauri MBBS (Dr. Ghauri of University of Texas Houston Health Science Center has no relevant financial relationships to disclose.)
Thy Nguyen MD (Dr. Nguyen of the University of Texas Health Science Center has no relevant financial relationships to disclose.)
Kazim Sheikh MD (Dr. Sheikh of University of Texas Houston Health Science Center has no relevant financial relationships to disclose.)
Randolph W Evans MD, editor. (Dr. Evans of Baylor College of Medicine received honorariums from Allergan and DepoMed for speaking engagements.)
Originally released November 21, 1997; last updated March 1, 2016; expires March 1, 2019

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.

 

• 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 because these patients commonly present with anterior thigh pain and weakness of quadriceps and iliopsoas muscles. It is now clear that isolated femoral neuropathy in diabetics is an extremely rare occurrence. When reviewed, most reported cases were clearly mislabeled, having more extensive disease affecting the lumbar plexus and roots, as seen with diabetic amyotrophy or radiculoplexopathy. Diabetic amyotrophy has become more easily recognized and, therefore, both clinically and electrophysiologically, no reliable reports of isolated diabetic femoral neuropathy have been published during the last 3 decades. However, a report claims that femoral nerve conduction abnormalities are present in diabetics who are clinically asymptomatic for polyneuropathy and that these changes progress with the development of neuropathy (Kurt et al 2009). These findings are not validated.

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