We present a patient with a spontaneous iliacus muscle hematoma, appearing immediately after a minor physical maneuver, presenting with pain and femoral neuropathy initially evidenced by massive quadriceps muscle fasciculations. [ncbi.nlm.nih.gov]

• Epilepsy

  While awaiting a favorable outcome, symptoms can be managed with skin-patches containing a local anesthetic drug, anti-inflammatory medications, certain epilepsy and antidepressant drugs known to relieve nerve-pain, and local injections with steroids. [cordingleyneurology.com]

  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 [emedicine.medscape.com]

• Ecchymosis

  There was noted to be a large thigh ecchymosis with a palpable mass in the left iliac fossa. Pulses were normal and no calf tenderness was present. Sensation was intact except for an area of decrease to pinprick on the medial left thigh. [healio.com]

  On physical examination, muscular atrophy was observed as the circumference of the right thigh measured at 10 cm proximal to the patellar upper margin was 40 cm while that of the left thigh was 46 cm ( Fig. 1-A ), and severe tenderness along with ecchymosis [ncbi.nlm.nih.gov]

• Hemophilia A

  Lucias SP: The neurologic complication of hemophilia. J Nerv Mem Disease 1944; 99:475-500. 2. Brower TD. Wilde AH: Femoral neuropathy in hemophilia. J Bone Joint Surg 1966; 48:487-492. 3. Butterticld WC. Neviaser RJ. [healio.com]

  Iliopsoas hematoma is usually a complication of anticoagulation, hemophilia, or trauma. It has not been described previously as a complication of posterior spinal decompression. [ncbi.nlm.nih.gov]

  Neuropathy in hemophilia. JAMA 1964;190:554–555 PubMed Google Scholar 5. Goodfellow J, Fearn CB, Matthews JM. Iliacus haematoma. A common complication of haemophilia. J Bone Joint Surg Br 1967;49:748–756 PubMed Google Scholar 6. [link.springer.com]

• Prolonged Bleeding

  Introduction Femoral neuropathy as a complication of prolonged bleeding in hemophilia has been well documented since Tallroth reported his first case in 1939 and second case in 1941. [healio.com]

• Pelvic Mass

  It can be caused by pelvic mass, retroperitoneal bleeding induced by anticoagulants, lithotomy position for a long time, positions causing overstretching of the femoral nerve, trauma, infection, systemic diseases such as diabetes or alcoholism, and radiation [ncbi.nlm.nih.gov]

• Abdominal Mass

  The most common cause is the compression of nerves around the inguinal area. 1, 2 Meralgia paresthetica occurs when lateral femoral cutaneous nerves are compressed by mechanical causes such as tight clothes, obesity, pregnancy and abdominal mass. [ncbi.nlm.nih.gov]

• Hypertension

  She had previously been physically healthy, with no underlying diseases such as hypertension, diabetes mellitus, or peripheral neuropathy. [ncbi.nlm.nih.gov]

  He had a past history of hypertension, and current medications were Dyazide and Persantine. An EKG revealed T-wave inversion on the inferior chest leads. A nitro-drip was begun and titrated to keep the blood pressure to greater than 100 systolic. [healio.com]

  In certain patients, drugs used to treat hypertension can instead raise blood pressure, although predicting which patients will have this paradoxical reaction is difficult. [m.webmd.com]

• Thrombosis

  Spontaneous bleeding and such subsequent palsy arose in a young woman during anticoagulant therapy for deep vein thrombosis. [ncbi.nlm.nih.gov]

  The patient had deep vein thrombosis (DVT) involving the right superficial femoral vein in the thigh and was on warfarin daily with irregular coagulation profile monitoring over the last 8 months. He was not a known case of thrombophilia. [indjvascsurg.org]

• Back Pain

  The patient, a 78-year-old man who had undergone antiplatelet treatment using ticlopidine, was admitted to our hospital with complaints of sudden-onset low abdominal and back pain. [ncbi.nlm.nih.gov]

  Doctors disagree on femoral neuropathy diagnosis/50yr old post meno..female Going on 8 months with significant pain in the left groin radiating to the inner thigh, knee and now low back pain with "tightness" when bending forward. [chiropractic-help.com]

  The iliopsoas muscle is a major body mover but seldom considered as a source of pain. It mimics low back pain, hip pain, and leg pain individually or in combination. [davidhinman.com]

  My original OS told me that there is NOTHING wrong with my knee - it's all coming from my back and I should consider back surgery!!! My pain management doc offered to give me more shots in my back. [bonesmart.org]

• Thigh Pain

  We describe a 58-year-old man who had progressive thigh pain, weakness, and numbness develop 13 years after cementless arthroplasty of his left hip. Plain radiographs showed substantial liner wear. [ncbi.nlm.nih.gov]

  " combines four Greek roots to mean "thigh pain with anomalous perception". [en.wikipedia.org]

  History A 67-year-old black woman presented one year prior to admission to this institution with left distal anterior thigh pain and left hip pain with an event of giving way of her left knee. [healio.com]

  It is derived from the Greek word, meros, meaning thigh, and algo, meaning pain. It is a syndrome of paresthesia and pain in the lateral and anterolateral thigh. [davidhinman.com]

• Quadriceps Muscle Weakness

  Admitted to the rehabilitation service 6 weeks after the fall, the patient was found to have a previously undiagnosed profound quadriceps muscle weakness. [ncbi.nlm.nih.gov]

  Signs [ 12 ] These may include: Quadriceps muscle weakness and wasting. Loss of knee jerk. Numbness along the medial side of the thigh and anteromedial side of the calf (the L2-L4 dermatomes - see figures below). [patient.info]

• Thigh Weakness

  CONCLUSIONS: Leg pain, thigh weakness, and atrophy are compatible with femoral neuropathy and are symptoms and signs compatible with recurrent large-bowel cancer. [ncbi.nlm.nih.gov]

  Key points • Femoral neuropathy presents, often acutely, with thigh weakness, numbness, and variable pain. [medlink.com]

• Suggestibility

  This case suggests that further diagnostic study may be warranted in patients with persistent quadriceps weakness or atrophy after a patellar dislocation, because this may suggest the presence of a femoral neuropathy. [ncbi.nlm.nih.gov]

• Flank Pain

  Only when flank pain became a prominent symptom was a CT scan ordered, which revealed tbe large retroperitoneal mass. The most common cause of femoral neuropathy is diabetes." [healio.com]

• Femoral Nerve Compression

  nerve Femoral nerve compression Femoral nerve lesion Femoral nerve palsy Femoral nerve paralysis (disorder) Femoral neuropathy Genitofemoral nerve entrapment Genitofemoral nerve neuralgia Genitofemoral neuropathy L femoral nerve lesion L femoral nerve [icd9data.com]

  The iliacus fascia is so strong that it is usually not stretched by the underlying hematoma, leading to femoral nerve compression in the illiopsoas gutter. [indjvascsurg.org]

  A low-lying fetal head may compress and damage the femoral nerve [11]. [journals.lww.com]

  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. [emedicine.medscape.com]

• Anterior Thigh Pain

  History A 67-year-old black woman presented one year prior to admission to this institution with left distal anterior thigh pain and left hip pain with an event of giving way of her left knee. [healio.com]

CT with contrast is usually required in workup. Patients with progressive neurological dysfunction should be taken up for decompression to avoid permanent disability. Financial support and sponsorship Nil. [indjvascsurg.org]

Differentials Conditions to consider in the differential diagnosis of femoral mononeuropathy include the following (see Presentation and Workup): Vasculitic neuropathy Lumbar plexopathies Lumbosacral disk syndromes Anatomy Knowledge of femoral nerve anatomy [emedicine.medscape.com]

[…] and external rotation of the thigh has been associated with femoral neuropathy, particularly after prolonged surgery.29 Lumbar disc disease, specifically L3-L4 herniations, can present as peripheral femoral neuropathy and should be ruled out.30 The workup [healio.com]

• T Wave Inversion

  An EKG revealed T-wave inversion on the inferior chest leads. A nitro-drip was begun and titrated to keep the blood pressure to greater than 100 systolic. Persantine 75 mg and aspirin 5 g, orally, three times a day were administered. [healio.com]

In the United States, duloxetine has been approved for the treatment of major depressive disorder, diabetic peripheral neuropathic pain and fibromyalgia in the adult population. [ncbi.nlm.nih.gov]

Non-somatic Treatment Psychological Treatment Depression Treatment Cognitive-Behavioural Treatment Rehabilitation Treatment Somatic Treatment Pharmacological treatment: Tricyclic antidepressants Anticonvulsives: carbamazepine, oxcarbazepine, gabapentine [pijn.com]

The prognosis was excellent with almost complete recovery within 10 weeks. [ncbi.nlm.nih.gov]

Use of prolonged digital pressure for post-procedural hemostasis is implicated as possible etiology. [ncbi.nlm.nih.gov]

We report this unusual complication that followed major pelvic surgery and also review the literature and discuss the possible etiology for prevention of this injury. [tmu.pure.elsevier.com]

Etiology Compression The femoral nerve is predisposed to compression within the psoas muscle. [emedicine.medscape.com]

Working with ATs to identify and implement methods to obtain more specific diagnostic information via surveillance will help researchers better understand the epidemiology of peripheral nerve injuries. Publisher Full Text New Search Next [unboundmedicine.com]

Midha R (1997) Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 40;1182–1189 PubMed CrossRef Google Scholar 6. [link.springer.com]

Epidemiology Femoral nerve lesions are uncommon. [patient.info]

The variability in clinical presentation of iatrogenic femoral nerve lesions, some new insights in their diverse pathophysiology, and in the diagnostic and treatment options are discussed with an update from the literature. [ncbi.nlm.nih.gov]

Such complications can be prevented by minimising the procedural time, avoiding injury to the vessels and maintaining optimal posture of patient's thigh by limiting abduction and external rotation of hip. [ncbi.nlm.nih.gov]