Femoral Neuropathy

Medically reviewed by Xixi Luo, M.D. — Written by Amanda Delgado — Updated on

September 17, 2018

Causes Symptoms Complications Diagnosis Treatments

Outlook Prevention

What is femoral neuropathy?

Femoral neuropathy, or femoral nerve dysfunction, occurs when you can’t
move or feel part of your leg because of damaged nerves, specifically the
femoral nerve. This can result from an injury, prolonged pressure on the
nerve, or damage from disease. In most cases, this condition will go away
without treatment. However, medications and physical therapy may be
necessary if symptoms don’t improve.
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What causes femoral neuropathy?

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The femoral nerve is one of the largest nerves in your leg. It’s located
near the groin and controls the muscles that help straighten yourMore
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and
move your hips. It also provides feeling in the lower part of your leg and
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the front of your Athigh. Because of where it’s located, damage to the
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femoral nerve is uncommon relative to neuropathies caused by damage

 to other nerves. When the femoral nerve is damaged, it affects your ability
to walk and may cause problems with sensation in your leg and foot. View
the femoral nerve on this BodyMap of the femur.

Damage to the femoral nerve can be the result of:

a direct injury

a tumor or other growth blocking or trapping part of your nerve

prolonged pressure on the nerve, such as from prolonged
immobilization

a pelvic fracture
radiation to the pelvis

hemorrhage or bleeding into the space behind the abdomen, which

is called the retroperitoneal space
a catheter placed into the femoral artery, which is necessary for
certain surgical procedures

Diabetes may cause femoral neuropathy. Diabetes can cause widespread

nerve damage due to fluctuations in blood sugar and blood pressure.
Nerve damage that affects your legs, feet, toes, hands, and arms is known
as peripheral neuropathy. There is currently some debate about whether
femoral neuropathy is truly a peripheral neuropathy or a form of diabetic
amyotrophy.

According to the National Institute of Diabetes and Digestive and Kidney

Diseases (NIDDK), diabetes is the most common reason for peripheral
neuropathy in people who’ve had diabetes for at least 25 years.

Signs of femoral neuropathy

This nerve condition can lead to difficulties moving around. Your leg or
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knee might feel weak, and you may be unable to put pressure on the
affected
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You might also feel
A D V E unusual
R T I S E M E N T sensations in your legs. They include:
 numbness in any part of the leg (typically the front and inside of the
thigh, but potentially all the way down to the feet)

tingling in any part of the leg

dull aching pain in the genital region
lower extremity muscle weakness
difficulty extending the knee due to quadriceps weakness
feeling like your leg or knee is going to give out (buckle) on you
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How serious is it?

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Prolonged
ACCEPT pressure placed on the femoral nerve can prevent blood
More from
information
flowing in the affected area. The decreased blood flow can result in tissue
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damage.
 If your nerve damage is the result of an injury, it may be possible that your
femoral vein or artery is also damaged. This could cause dangerous
internal bleeding. The femoral artery is a very large artery that lies close
to the femoral nerve. Trauma often damages both at the same time. Injury
to the artery or bleeding from the artery can cause compression on the
nerve.

Additionally, the femoral nerve provides sensation to a major portion of

the leg. This loss of sensation can lead to injuries. Having weak leg
muscles can make you more prone to falling. Falls are of particular
concern in older adults because they can cause hip fractures, which are
very serious injuries.

Diagnosing femoral neuropathy

Initial tests

To diagnose femoral neuropathy and its cause, your doctor will perform a
comprehensive physical exam and ask questions about recent injuries or
surgeries, as well as questions about your medical history.

To look for weakness, they will test specific muscles that receive
sensation from the femoral nerve. Your doctor will probably check your
knee reflexes and ask about changes in feeling in the front part of the
thigh and the middle part of the leg. The goal of the evaluation is to
determine whether the weakness involves only the femoral nerve or if
other nerves also contribute.

Additional testing might include:

Nerve conduction

Nerve
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An abnormal response, such as a slow time for electrical signals to travel

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through your nerves, usually indicates damage to the nerve in question.
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Electromyography (EMG)
 Electromyography (EMG) should be performed after the nerve conduction
test to see how well your muscles and nerves are working. This test
records the electrical activity present in your muscles when the nerves
that lead to them are active. The EMG will determine whether the muscle
responds appropriately to stimulation. Certain medical conditions cause
muscles to fire on their own, which is an abnormality that an EMG can
reveal. Because nerves stimulate and control your muscles, the test can
identify problems with both muscles and nerves.

MRI and CT scans

An MRI scan can look for tumors, growths, or any other masses in the
area of the femoral nerve that could cause compression on the nerve. MRI
scans use radio waves and magnets to produce a detailed image of the
part of your body that is being scanned.

A CT scan can also look for vascular or bone growths.

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Treatment options
The first step in treating femoral neuropathy is dealing with the underlying
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condition to improve
or cause. your experience
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be to relieve the compression. Occasionally in mild injuries, such as mild
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compression or a stretch injury, the problem may resolve spontaneously.
For people with Adiabetes, bringing blood sugar levels back to normal may
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alleviate nerve dysfunction. If your nerve doesn’t improve on its own,

 you’ll need treatment. This usually involves medications and physical
therapy.

Medications

You might have corticosteroid injections in your leg to reduce

inflammation and get rid of any swelling that occurs. Pain medications can
help relieve any pain and discomfort. For neuropathic pain, your doctor
may prescribe medications, such as gabapentin, pregabalin, or SUBSCRIBE

amitriptyline.

Therapy

Physical therapy can help build up the strength in your leg muscles again.
A physical therapist will teach you exercises to strengthen and stretch
your muscles. Undergoing physical therapy helps to reduce pain and
promote mobility.

You might need to use an orthopedic device, such as a brace, to assist

you with walking. Usually, a knee brace is helpful in preventing knee
buckling.

Depending on how severe the nerve damage is and how much trouble
you’re having moving around, you might also need occupational therapy.
This type of therapy helps you learn to do regular tasks like bathing and
other self-care activities. These are called “activities of daily living.” Your
doctor might also recommend vocational counseling if your condition
forces you to find another line of work.

Surgery

Your doctor might recommend surgery if you have a growth blocking your
femoral
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nerve.
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Long-term outlook after treatment

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 You might be able to heal fully after you treat the underlying condition. If
the treatment isn’t successful or if the femoral nerve damage is severe,
you might permanently lose feeling in that part of your leg or the ability to
move it.
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Tips to prevent nerve damage

You can lower your risk of femoral neuropathy caused by diabetes by
keeping your blood sugar levels under control. This helps protect your
nerves from damage caused by this disease. Preventive measures would
be directed at each cause. Talk to your doctor for advice about what
preventive measures would be the best for you.

Maintaining an active lifestyle helps to keep your leg muscles strong and
improve stability.

Last medically reviewed on September 13, 2017

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Guillain-Barré Syndrome
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Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA — Written

by Jacquelyn Cafasso — Updated on February 27, 2019
 Causes Symptoms Diagnosis Treatment Complications
Outlook

What is Guillain-Barré syndrome?

Guillain-Barré syndrome is a rare but serious autoimmune disorder in
which the immune system attacks healthy nerve cells in your peripheral
nervous system (PNS).

This leads to weakness, numbness, and tingling, and can eventually

cause paralysis.

The cause of this condition is unknown, but it’s typically triggered by an

infectious illness, such as gastroenteritis (irritation of the stomach or
intestines) or a lung infection.

Guillain-Barré is rare, affecting only about 1 in 100,000 Americans,

according to the National Institute of Neurological Disorders and Stroke.

There’s no cure for the syndrome, but treatment can reduce the severity
of your symptoms and shorten the duration of the illness.

There are multiple types of Guillain-Barré, but the most common form is
acute inflammatory demyelinating polyradiculoneuropathy (CIDP). It
results in damage to myelin.

Other types include Miller Fisher syndrome, which affects the cranial
nerves.
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 What causes Guillain-Barré syndrome?
The precise cause of Guillain-Barré is unknown. According to the Centers
for Disease Control and Prevention (CDC)  , about two-thirds of people
with Guillain-Barré develop it soon after they’ve been sick with diarrhea or
a respiratory infection.

This suggests that an improper immune response to the previous illness

triggers the disorder.

Campylobacter jejuni infection has been associated with Guillain-Barré.

Campylobacter is one of the most common bacterial causes of diarrhea in
the United States. It’s also the most common risk factor for Guillain-Barré.

Campylobacter is often found in undercooked food, especially poultry.

The following infections have also been associated with Guillain-Barré:

influenza
cytomegalovirus (CMV), which is a strain of the herpes virus

Epstein-Barr virus (EBV) infection, or mononucleosis

mycoplasma pneumonia, which is an atypical pneumonia caused by

bacteria-like organisms

HIV or AIDS

Anyone can get Guillain-Barré, but it’s more common among older adults.

In extremely rare cases, people can develop the disorder days or weeks
after receiving a vaccination  .

The CDC and the Food and Drug Administration (FDA) have systems in
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place to monitor the safety of vaccines, detect early symptoms of side
effects,
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The CDC says  that research indicates you’re more likely to get Guillain-
Barré from the flu, rather than the vaccine.
 What are the symptoms of Guillain-Barré
syndrome?
In Guillain-Barre syndrome, your immune system attacks your peripheral
nervous system.

The nerves in your peripheral nervous system connect your brain to the
rest of your body and transmit signals to your muscles.

The muscles won’t be able to respond to signals they receive from your
brain if these nerves are damaged.

The first symptom is usually a tingling sensation in your toes, feet, and
legs. The tingling spreads upward to your arms and fingers.

The symptoms can progress very rapidly. In some people, the disease
can become serious in just a few hours.

The symptoms of Guillain-Barré include:

tingling or prickling sensations in your fingers and toes

muscle weakness in your legs that travels to your upper body and
gets worse over time
difficulty walking steadily

difficulty moving your eyes or face, talking, chewing, or swallowing

severe lower back pain

loss of bladder control

fast heart rate

difficulty breathing

paralysis
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How is Guillain-Barré syndrome diagnosed?

Guillain-Barré is difficult to diagnose at first. This is because the symptoms
are very similar to those of other neurological disorders or conditions that
affect the nervous system, such as botulism, meningitis, or heavy metal
poisoning.

Heavy metal poisoning may be caused by substances such as lead,

mercury, and arsenic.

Your doctor will ask questions about specific symptoms and your medical
history. Be sure to tell your doctor about any unusual symptoms and if
you’ve had any recent or past illnesses or infections.

The following tests are used to help confirm a diagnosis:

Spinal
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from
your spine in your lower back. This fluid is called cerebrospinal fluid. Your 
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cerebrospinal fluid is then tested to detect protein levels.
 People with Guillain-Barré typically have higher-than-normal levels of
protein in their cerebrospinal fluid.

Electromyography

An electromyography is a nerve function test. It reads electrical activity

from the muscles to help your doctor learn if your muscle weakness is
caused by nerve damage or muscle damage.

Nerve conduction tests

Nerve conduction studies may be used to test how well your nerves and
muscles respond to small electrical pulses.

How is Guillain-Barré syndrome treated?

Guillain-Barré is an autoimmune inflammatory process that’s self-limiting,
meaning it will resolve on its own. However, anyone with this condition
should be admitted to a hospital for close observation. The symptoms can
quickly worsen and can be fatal if untreated.

In severe cases, people with Guillain-Barré can develop full-body

paralysis. Guillain-Barré can be life-threatening if paralysis affects the
diaphragm or chest muscles, preventing proper breathing.

The goal of treatment is to lessen the severity of the immune attack and
support your body functions, such as lung function, while your nervous
system recovers.

Treatments may include:

Plasmapheresis (plasma exchange)

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The immune system produces proteins called antibodies that normally
attack
ACCEPTharmful foreign substances, such as bacteria and viruses.More information
Guillain-
Barré occurs when your immune system mistakenly makes antibodies that 
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attack the healthy nerves of your nervous system.
 Plasmapheresis is intended to remove the antibodies attacking the nerves
from your blood.

During this procedure, blood is removed from your body by a machine.

This machine removes the antibodies from your blood and then returns
the blood to your body.

Intravenous immunoglobulin

High doses of immunoglobulin can also help block the antibodies causing
Guillain-Barré. Immunoglobulin contains normal, healthy antibodies from
donors.

Plasmapheresis and intravenous immunoglobulin are equally effective. It’s

up to you and your doctor to decide which treatment is best.

Other treatments

You may be given medication to relieve pain and prevent blood clots
while you’re immobile.

You’ll likely receive physical and occupational therapy. During the acute
phase of the illness, caregivers will manually move your arms and legs to
keep them flexible.

Once you begin to recover, therapists will work with you on muscle
strengthening and a range of activities of daily living (ADLs). This can
include personal care activities, like getting dressed.
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 What are the potential complications of Guillain-
Barré syndrome?
Guillain-Barré affects your nerves. The weakness and paralysis that
occurs can affect multiple parts of your body.

Complications may include difficulty breathing when the paralysis or

weakness spreads to muscles that control breathing. You may need a
machine called a respirator to help you breathe if this occurs.

Complications can also include:

lingering weakness, numbness, or other odd sensations even after

recovery

heart or blood pressure problems

pain

slow bowel or bladder function

blood clots and bedsores due to paralysis

What is the long-term outlook?

The recovery period for Guillain-Barré can be long, but most people
recover.

In general, symptoms will get worse for two to four weeks before they
stabilize. Recovery can then take anywhere from a few weeks to a few
years, but most recover in 6 to 12 months.

About 80 percent of people affected by Guillain-Barré can walk

independently at six months, and 60 percent recover their regular muscle
strength in one year.
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For some, recovery takes longer. Around 30 percent  still experience
some weakness after three years.
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About 3 percentAof
D V Epeople
R T I S E M E N Taffected by Guillain-Barré will experience a

relapse of their symptoms, like weakness and tingling, even years after
 the original event.

In rare cases, the condition can be life-threatening, especially if you don’t

get treatment. Factors that may lead to a worse outcome include:

advanced age

severe or rapidly progressing illness

delay of treatment, which can result in more nerve damage

prolonged use of a respirator, which can predispose you to
pneumonia

Blood clots and bedsores that result from being immobilized can be
reduced. Blood thinners and compression stockings may minimize
clotting.

Frequent repositioning of your body relieves prolonged body pressure

that leads to tissue breakdown, or bedsores.

In addition to your physical symptoms, you may experience emotional

difficulties. It can be challenging to adjust to limited mobility and an
increased dependence on others. You may find it helpful to talk to a
therapist.

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