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Femoral Neuropathy

Lesion of Femoral Nerve


Presentation

  • The case presented herein is remarkable since the muscle hematoma appeared after a nonviolent maneuver, fasciculations were present at onset, and conservative management was sufficient for a full recovery.[ncbi.nlm.nih.gov]
  • Abstract A case of femoral neuropathy secondary to psoas muscle hematoma in a patient on warfarin sodium anticoagulation therapy is presented. Computed tomography was used to establish the diagnosis.[ncbi.nlm.nih.gov]
  • Abstract Kidney transplantation related femoral neuropathy can mimic epidural catheter related radiculopathy in clinical presentation.[ncbi.nlm.nih.gov]
  • Pseudotumours may also present with a major nerve palsy. Two cases of femoral neuropathy due to pseudotumour masses caused by metal-on-metal resurfacing arthroplasty are presented.[ncbi.nlm.nih.gov]
  • Abstract We present the case of a 63-year-old woman with a six-year history of rheumatoid arthritis (RA) and a left iliopsoas bursitis.[ncbi.nlm.nih.gov]
Infertility
  • We report a case of a 35-year-old woman with infertility who developed unilateral femoral nerve palsy after laparoscopy and hysteroscopy.[ncbi.nlm.nih.gov]
Aspiration
  • Percutaneous aspiration of the cyst was performed. Cultures of the fluid were negative and cytopathologic examination showed necrotic debris without malignant cells.[ncbi.nlm.nih.gov]
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]
  • pain with anomalous perception".[en.wikipedia.org]
  • He reported that two months previously he had a similar attack of lateral thigh pain which past spontaneously with anti inflammatory drugs after two days which he, wrongly, associated with an attack of gout which he was also suffering from at that time[chiropractic-help.com]
  • Pain may be increased with hip extension and relieved with external rotation of the hip. If compression occurs at the inguinal region, no hip flexion weakness is present.[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]
  • Keywords: Femoral neuropathy, Meralgia paresthetica, Iliacus hematoma INTRODUCTION Femoral neuropathy, an uncommon peripheral neuropathy, may show symptoms such as atrophy of quadriceps muscle, weakness of hip flexion and knee extension, decreased or[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]
  • Postoperatively, both patients complained of ipsilateral thigh weakness. Electromyography and nerve conduction studies indicated femoral nerve neuropathy. Muscle weakness gradually resolved.[ncbi.nlm.nih.gov]
  • Key points • Femoral neuropathy presents, often acutely, with thigh weakness, numbness, and variable pain.[medlink.com]
Neglect
  • When the patient fails to address associated suffering, it is easy for clinicians to neglect this type of morbidity.[ncbi.nlm.nih.gov]

Workup

  • 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]
Nephrolithiasis
  • Abstract Management of nephrolithiasis within a pelvic kidney presents a novel challenge to the urologist. We report on a patient who underwent ureteral stent placement prior to extracorporeal shock-wave lithotripsy (ESWL).[ncbi.nlm.nih.gov]

Treatment

  • Abstract 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]
  • However, treatment of these patients is still controversial, both conservative and surgical treatments have been advocated.[ncbi.nlm.nih.gov]
  • It is usually diagnosed in adults with haemophilia or those on anticoagulation treatment and may occur after trauma.[ncbi.nlm.nih.gov]
  • Determining the precise aetiology, establishing a diagnosis and subsequent treatment of femoral nerve injury remains a difficult task, with conservative management remaining the treatment benchmark.[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]

Prognosis

  • This type of femoral neuropathy has an excellent prognosis and only physiotherapy is necessary to aid muscular function.[ncbi.nlm.nih.gov]
  • The prognosis was found to be excellent with complete recovery within eight to ten weeks. The complication is preventable by using lateral thigh supports limiting the degree of abduction.[ncbi.nlm.nih.gov]
  • The prognosis was excellent with almost complete recovery within 10 weeks.[ncbi.nlm.nih.gov]
  • Following the evaluation of anatomy, possible pathogenesis and CT scanning findings, the role of early diagnosis is emphasized in the assessment of prognosis and for successful operative decompression.[ncbi.nlm.nih.gov]
  • Abstract Diabetic femoral neuropathy is an uncommon, unpleasant and sometimes disabling condition, on account of both pain and muscular atrophy, whose long-term prognosis has not previously been documented.[ncbi.nlm.nih.gov]

Etiology

  • Follow-Up Studies Granuloma, Foreign-Body/diagnostic imaging Granuloma, Foreign-Body/physiopathology Granuloma, Foreign-Body/surgery Hip Prosthesis* Humans Male Middle Aged Osteoarthritis, Hip/diagnostic imaging Osteoarthritis, Hip/surgery* Pain/etiology[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.[ncbi.nlm.nih.gov]
  • Abstract Femoral neuropathy can result from diverse etiologies following abdominal surgery. We describe four cases of postoperative femoral neuropathy after proctological procedures that were carried out at our hospital.[ncbi.nlm.nih.gov]

Epidemiology

  • 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]
Sex distribution
Age distribution

Pathophysiology

  • The literature is reviewed with regard to the pathophysiology, clinical presentation, and therapy of this case. Surgical decompression is suggested to shorten the recovery period and minimize residual neurological deficit.[ncbi.nlm.nih.gov]
  • The pathophysiology contributing to this operative complication as well as measures for prevention and treatment are discussed.[ncbi.nlm.nih.gov]
  • The possible pathophysiology including direct compression and nerve ischemia, is discussed.[ncbi.nlm.nih.gov]
  • 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]
  • The pathophysiology of neural injury includes compression, stretch, transection, ligation, iliopsoas hematoma, ischemia, and cement encapsulation.[ncbi.nlm.nih.gov]

Prevention

  • The preventive measures suggested are to use a retractor with appropriate blade depth.[ncbi.nlm.nih.gov]
  • The pathophysiology contributing to this operative complication as well as measures for prevention and treatment are discussed.[ncbi.nlm.nih.gov]
  • This rare complication, secondary to extreme flexion, abduction and lateral rotation of the hip joint, can be prevented by careful preoperative patient positioning.[ncbi.nlm.nih.gov]
  • Pathogenesis and prevention of the complication of femoral neuropathy are discussed in the following report.[ncbi.nlm.nih.gov]
  • The complication is preventable by using lateral thigh supports limiting the degree of abduction.[ncbi.nlm.nih.gov]

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