ISSN 2398-2969      

Femoral neuropathy

icanis
Contributor(s):

Paul Cuddon


Introduction

  • Uncommon as isolated peripheral lesion since nerve is well protected by muscle.
  • Cause: pressure on medial thigh.
    • Bilateral femoral nerve injury has been seen after extreme hip flexion.
    • External trauma.
    • Peripheral nerve neoplasia.
  • Signs: unable to extend stifle, non-weight bearing, absence patellar of reflex, decreased skin sensation on medial thigh.
  • Diagnosis: signs, electrophysiology.

Pathogenesis

Etiology

  • Same as nerve trauma neuritis Nerve trauma neuropathy.
  • Pressure on medial thigh during perineal surgery, eg due to positioning hindlimbs over edge of operating table.
  • Neoplasia affecting nerve as it passes through iliopsoas muscle, or within the nerve anywhere along its length.
  • Trauma to femur (fractures).

Pathophysiology

  • Constant pressure on femoral nerve → development of neuropraxia (localized conduction block without degenerative changes), local demyelination or axonotmesis (axon interruption), the latter leading to Wallerian-type degeneration distally → loss of function to extensor muscles of stifle → loss of sensation to medial thigh → neurogenic atrophy of quadriceps muscles.

Timecourse

  • Immediately after injury: loss of function.
  • Quadriceps muscle atrophy will be delayed by 7-10 days.
  • Slow, progressive signs if peripheral nerve tumor.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bailey C S (1987) Cutaneous sensory testing in the dog. J Vet Int Med 1 (3), 128-135 PubMed.

Other sources of information

  • Summers B Aet al(1995)diseases of the peripheral nervous system.In:Veterinary Neuropathology.Mosby. pp 402-279.
  • Braund K G (1994)Clinical syndromes in veterinary neurology.Mosby. pp 277-279.

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