2023 American Academy of Neurology Abstract Website

Objective:

The aim of this comprehensive study was to gain better understanding of the risk factors, etiologies, electrodiagnostic (EDX) features, and clinical course of femoral neuropathy.

Background:

Femoral neuropathies can cause severe and prolonged debility. Previous literature has reviewed lateral femoral cutaneous neuropathy as well as the femoral predominance in lumbosacral radiculoplexus neuropathy, but there are limited studies addressing femoral neuropathy itself.

Design/Methods:

We identified patients evaluated at Mayo Clinic Rochester between January 1, 1999 and July 31, 2019 with possible new femoral neuropathy ascertained via ICD 9/10 diagnosis codes presenting within 6 months of symptom onset. A retrospective review of 1084 records was performed.

Results:

We identified 165 cases of femoral neuropathy for inclusion. The most common femoral neuropathy etiologies included: compressive (38%) from retroperitoneal/inguinal lesions or prolonged positioning; stretch (35%) post-operatively; and toxic/inflammatory (10%). Presenting symptoms included weakness (96%), sensory loss (73%), and pain (53%). Presenting motor physical exam findings demonstrated moderate weakness (34%) or no activation (26%) of knee extension and mild (32%) or moderate (35%) weakness of hip flexion. 121 (73%) patients underwent EDX testing including 23 with femoral motor nerve conduction studies. Treatment often involved physical therapy (89%) and was otherwise etiology-specific. In patients with follow-up data available (160), 80% experienced subjective clinical improvement at last follow-up with mean time to initial improvement 3.3 months and mean time to recovery at final follow up 14.7 months. 28 (17.5%) of patients experienced no symptomatic improvement at final follow up.

Conclusions:

In our cohort, the most common etiologies of femoral neuropathy are compression or stretch. Although initial morbidity is high, motor recovery is common but often prolonged.