Enhancing functional recovery following postpartum femoral neuropathy: early neurorehabilitation and multidisciplinary obstetric care

Author:

Moita Gonçalves Eugénio123ORCID,Lanzaro Camile4,Silva Luísa Cunha5,Correia Pedro6,Gonçalves José Vítor12,Azevedo Marta7,Carrapatoso Inês4,Silva João Pedro5,Carvalho Carolina7,Cruz André7

Affiliation:

1. Physical Medicine and Rehabilitation Department Centro Hospitalar Vila Nova de Gaia‐Espinho Porto Portugal

2. Faculty of Medicine University of Porto Porto Portugal

3. Egas Moniz Health Alliance Clinical Academic Center Aveiro Portugal

4. Anesthesiology Department Unidade Local de Saúde do Alto Minho Viana do Castelo Portugal

5. Gynecology and Obstetrics Department Unidade Local de Saúde do Alto Minho Viana do Castelo Portugal

6. Neurology Department Unidade Local de Saúde do Alto Minho Viana do Castelo Portugal

7. Physical Medicine and Rehabilitation Department Unidade Local de Saúde do Alto Minho Viana do Castelo Portugal

Abstract

AbstractPostpartum femoral neuropathy has a reported incidence of less than 1% and its total recovery time extends up to 6 months to a year. A multidisciplinary approach is vital to rule out permanent disability and to assure a correct diagnosis and earlier rehabilitation. We report a case of a 37‐year‐old puerperal woman with a history of intrapartum epidural analgesia, who presented post‐labor unilateral lower‐limb motor weakness and sensory loss, with functional compromise on independent gait. A multidisciplinary team consisting of an anesthesiologist, a physiatrist, a neurologist, and an obstetrician was then established. In the initial physiatry and neurology assessment, the patient reported pain (numerical rating scale 7/10) over the inguinal ligament, lower limb hypoesthesia, and muscle weakness. Femoral neuropathy was suspected. Magnetic resonance imaging ruled out potential complications related to the anesthetic procedure. The patient was then enrolled in a supervised rehabilitation program and, 3 weeks later, electrodiagnostic studies confirmed the initial suspicion. Two months later, the patient had regained lower‐limb active range of motion and no pain nor paresthesia was reported. Our case report describes how an early multimodal rehabilitation program within a multidisciplinary framework allows for sooner neuromotor function improvement and activities of daily living independence.

Publisher

Wiley

Subject

Obstetrics and Gynecology,General Medicine

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