Femoral neuropathy: a clinical review - abstract

ABSTRACT

Femoral neuropathy is a common cause of quadriceps wasting and weakness. The usual clinical picture involves pain and hyperaesthesia in the anteromedial aspect of the thigh, quadriceps weakness with muscle wasting and loss of the knee jerk. The present study reviews the aetiological factors, clinical features and prognosis in a group of 42 patients. Electrophysiological studies were performed in 33, and the condition graded as mild, moderate or severe. Diabetes mellitus was the commonest cause, but accident trauma, operative surgery, retroperitoneal haemorrhage and hyperglobinaemic states were other important associated conditions. A few palsies occurred spontaneously for no apparent reason. The symptom of pain alone was present in 14 cases. It was usually severe, often burning in character and located in the anterior thigh compartment. Weakness was the presenting feature in 15 patients who often complained of falling. In 16 patients pain and weakness were both present. The condition is usually unilateral, but bilateral involvement was seen in 4 diabetics, in one patient who suffered local trauma, and in one patient classified as idiopathic. In the acute stage when clinical paralysis appears to be complete electrophysiologic studies are a useful guide to outcome. Prognosis was good in the mild cases but delayed in severe cases. It is important that practitioners be aware of this condition, as unnecessary special examinations and operations may be avoided if the condition is correctly diagnosed (AU)