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Neurology (Expert Forum)
Femoral Nerve Palsy
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Femoral Nerve Palsy
by Steve Speer, Oct 01, 1999 12:00AM
I have read several people questions on Nerve Numbness. I believe my question is unique.
My wife had a 2nd Hip replacement in July 1999, which has left her numb in the femoral nerve. The doctor beleive that the nerve was stretched during the surgery and movement of leg lengthening. We had the EMG done this week and the result indicate that the is no involuntary muscle control of the quadruscept. She is experiencing no pain, but occasional tingling in her leg. The EMG could not even stimulate a contraction. I understand that the results could change over a 9 month period of time. She is 31 years old. All other muscle control in her leg are working correctly. She is attending physical therapy twice a week that includes water therapy as well.
My question is. In the movie Lorenzo's Oil it was determined that the Mylan sheath around the nerve could be restored with a mixture of Virgin Olive Oil and Rape Seed oil. If indeed the sheath around my wife's nerve was stretched is there any medication, foods, or oils that have shown positive effects on nerve injury improvement. The EMG doctor thinks that the stretching can be repaired over time. Is this approach of medication for repair out there in the doctors world?
Thank you,
Steve
My wife had a 2nd Hip replacement in July 1999, which has left her numb in the femoral nerve. The doctor beleive that the nerve was stretched during the surgery and movement of leg lengthening. We had the EMG done this week and the result indicate that the is no involuntary muscle control of the quadruscept. She is experiencing no pain, but occasional tingling in her leg. The EMG could not even stimulate a contraction. I understand that the results could change over a 9 month period of time. She is 31 years old. All other muscle control in her leg are working correctly. She is attending physical therapy twice a week that includes water therapy as well.
My question is. In the movie Lorenzo's Oil it was determined that the Mylan sheath around the nerve could be restored with a mixture of Virgin Olive Oil and Rape Seed oil. If indeed the sheath around my wife's nerve was stretched is there any medication, foods, or oils that have shown positive effects on nerve injury improvement. The EMG doctor thinks that the stretching can be repaired over time. Is this approach of medication for repair out there in the doctors world?
Thank you,
Steve
Doctor's Answer
by CCF Neuro[P] MD, RPS, Oct 01, 1999 12:00AM
Dear Steve:
Lorenzo's oil was used to treat a condition named X-linked adrenal leukodystrophy. This is a disorder where long chain fatty acids can not be utilized and therefore build up and somehow induce microglia to be activated and induce demyelination and death of the myelin producing cell the oligodendrocyte. Lorenzo's oil (diet of unsaturated fatty acids) lowers the levels of circulating very long chain fatty acids and theoretically lowers the level in the central nervous system. This would therefore prevent the loss of myelin or the demyelinating process. It has no benefit for inducing myelin formation.
I am not sure what type of lesion that your wife had during surgery, it might have been an axonal cut, demyelinated conduction block, etc. If it were only a stretch then the axon is still in place (although injured) and just demyelination has occured from the trauma. In this case, then the remyelination process will occur over a few months and she should regain function. It is difficult to tell how much function, but time will tell. Sounds like her trauma was significant to loose all voluntary movement.
I hope that I explained things well enough for you to understand.
Sincerely,
CCF Neuro MD
Lorenzo's oil was used to treat a condition named X-linked adrenal leukodystrophy. This is a disorder where long chain fatty acids can not be utilized and therefore build up and somehow induce microglia to be activated and induce demyelination and death of the myelin producing cell the oligodendrocyte. Lorenzo's oil (diet of unsaturated fatty acids) lowers the levels of circulating very long chain fatty acids and theoretically lowers the level in the central nervous system. This would therefore prevent the loss of myelin or the demyelinating process. It has no benefit for inducing myelin formation.
I am not sure what type of lesion that your wife had during surgery, it might have been an axonal cut, demyelinated conduction block, etc. If it were only a stretch then the axon is still in place (although injured) and just demyelination has occured from the trauma. In this case, then the remyelination process will occur over a few months and she should regain function. It is difficult to tell how much function, but time will tell. Sounds like her trauma was significant to loose all voluntary movement.
I hope that I explained things well enough for you to understand.
Sincerely,
CCF Neuro MD
Her loss of movement is only in that muscle of the quadrucept. I have been reading about nerve grafts and other nerve related items. Is there any know efforts that are to aid in the process of healing the stretch.
In addition, is there a way to tell if it is just a stretch, or if the problem is more severe like a tear, or separation of the nerve?
Steve
The EMG should be telling if the lesion is a focal demyelinating variety or the tear of the axon. Ask the neurologist and he/she should be able to tell you. This might be problematic if the EMG was done within a week or so of the surgery? If there has been a complete tear then a surgeon would already be involved so I am guessing that it was just a focal demyelinating lesion. I hope things resolve well.
Sincerely,
CCF Neuro MD
Also what would be the indications of sensations that might be felt if the nerve was in the process of regeneration.
Thanks
The EMG would be the indicator of whether there was demyelination or axonal loss. As the nerve regenerates, there would be regain of function and sensation.
I hope your wife regain function.
Sincerely,
CCF Neuro MD