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Results for “Peroneal Neuropathies”

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At least 19 recordsLinked to original sources

PubMed1998

Outcome of peroneal neuropathies in patients with systemic malignant disease.

BACKGROUND: Peroneal neuropathies in patients with systemic cancer previously have been attributed to weight loss, but to the authors' knowledge other associated conditions have not been assessed, and the outcome of peroneal neuropathies in cancer patients has not been studied. METHODS: A retrospective chart review of patients evaluated at the Mayo Clinic between 1984 and 1993 with systemic malignant disease and a clinical diagnosis of peroneal neuropathy was performed to define factors associated with peroneal neuropathies and to assess outcome. All patients underwent neurologic examination and electromyography. RESULTS: Fifty-eight patients with systemic malignant disease were found to have a peroneal neuropathy. Peroneal neuropathies occurred more often in men (45 patients) than in women (13 patients). The median age of the patients was 70 years. The most common cancers were hematologic (12 patients) and pulmonary (11 patients), followed by tumors of the prostate (8 patients), gastrointestinal tract (7 patients), transitional cell (5 patients), breast (5 patients), and colon (5 patients), as well as sarcomas and melanoma (5 patients). The median time to the diagnosis of peroneal neuropathy after the diagnosis of cancer was 5 months. At the time of diagnosis, 34 patients had severe deficits, 19 had moderate deficits, and 5 had mild deficits. Associated factors included weight loss (occurring in 60% of patients), leg crossing (35% of patients), recent chemotherapy (16% of patients), cutaneous vasculitis (5% of patients), and local metastatic lesions (3% of patients). In nearly 50% of patients, peroneal neuropathy improved (25.9%) or resolved (22.4%). In 39.7% of patients, follow-up was inadequate because death occurred soon after diagnosis. Of the patients with adequate follow-up before death, 80% had either improvement (42.9%) or resolution (37.1%). CONCLUSIONS: For those patients with systemic malignant disease in whom peroneal neuropathy develops, the outcome of the neuropathy is good, with the majority of patients achieving partial or complete resolution.

Adult↗

PubMed1970

Atypical deep peroneal neuropathy in presence of accessory deep peroneal nerve.

The clinical and electrophysiological findings in two patients with a deep peroneal neuropathy occurring in the presence of significant innervation of the extensor digitorum brevis muscle by the accessory deep peroneal nerve are reported. This nerve is a branch of the superficial peroneal nerve which was not involved in either cases reported. An awareness of this anatomical variation of innervation of the extensor digitorum brevis muscle is important for the correct clinical and electromyographic evaluations of deep peroneal nerve lesions. The electromyographic findings in this situation are sufficiently characteristic to identify clearly this anatomical variant. From a clinical point of view, residual function in the lateral portion of the extensor digitorum brevis muscle, in the face of an otherwise complete deep peroneal palsy, should suggest this anatomical variation.

Adult↗

PubMed1998

Common peroneal neuropathy secondary to squatting during childbirth.

BACKGROUND: Common peroneal neuropathy occurs fairly frequently in the adult population; however, very few cases of peroneal neuropathy after prolonged squatting have been reported. CASE: A 29-year-old woman noted right foot numbness and weakness immediately after childbirth, which involved 15-30 minutes of pushing in a squatting position. Physical examination and an electrodiagnostic study confirmed a common peroneal neuropathy. The patient was referred for rehabilitation, including bracing and gait training, which improved substantially her mobility and function. CONCLUSION: Prolonged squatting should be minimized or avoided. A high index of suspicion for peroneal neuropathy after prolonged squatting must be present. Early diagnosis and treatment may limit the number of complications in these patients, particularly falls.

Adult↗

PubMed2000

Common peroneal neuropathy due to surfing.

Common peroneal neuropathy is uncommon in children and adolescents. In this population, it is usually caused by direct nerve injury at the fibular head level. Most commonly, the nerve is damaged during sports-related blunt trauma. Other etiologies such as hereditary neuropathies and bone tumors are much less frequent. In some cases, repetitive microtrauma to the peroneal nerve is felt to cause neuropathy. We describe the case of a teenager who developed common peroneal neuropathy in association with prolonged wave-surfing in the presence of weight loss.

Adolescent↗

PubMed2005

Involvement of superficial peroneal sensory nerve in common peroneal neuropathy.

Motor involvement in common peroneal neuropathy (CPN) frequently shows a selective pattern with regard to deep and superficial divisions of the peroneal nerve, by clinical examination and needle electromyography. The involvement of the sensory branch of the superficial peroneal nerve (SPN) has not been well established using nerve conduction studies. Among 42 cases of electrophysiologically defined CPN in 35 patients, 37 (88%) had clinical or electrophysiologic evidence for SPN involvement, but only 20 had diminished superficial peroneal sensory response (SPSR) amplitudes. Many of the cases involving normal SPSRs had significant axonal loss involving deep peroneal motor fibers. Sparing of the superficial peroneal sensory fibers provides further evidence for the selective vulnerability of different nerve fascicles to injury. This is an important pattern to recognize; from a practical standpoint, focal segmental conduction abnormalities in the motor nerve and EMG findings can help to differentiate these lesions from L-5 radiculopathy.

Adult↗

PubMed2005

Practice parameter: utility of electrodiagnostic techniques in evaluating patients with suspected peroneal neuropathy: an evidence-based review.

An evidence-based review of electrodiagnostic (EDX) techniques in the evaluation of peroneal neuropathy was conducted to determine whether these techniques are useful for diagnosis and prognostication in this disorder. A Medline search and a review of relevant sources were performed in 1999 and updated through July 2003 to identify articles describing the use of EDX in patients suspected to have peroneal neuropathy. From the 499 articles identified, 112 articles describing motor and sensory nerve conduction studies and needle electromyography in peroneal neuropathy were reviewed in detail; 11 articles met the predetermined literature inclusion criteria for the adequacy of EDX techniques employed. Six articles provided Class III evidence in support of a role for nerve conduction studies in making the diagnosis of peroneal neuropathy; five articles provided Class IV evidence. Implicit in making the diagnosis were normal EDX findings outside the distribution of the peroneal nerve. The current literature supports the use of EDX in patients with suspected peroneal neuropathy (Level C recommendation).

Electrodiagnosis↗

PubMed2006

Peroneal neuropathy following successful bariatric surgery. Case report and review of the literature.

Peroneal neuropathy has been observed in starvation, anorexia, and other situations of extreme weight loss. The authors report a case in which sequential bilateral peroneal neuropathies developed after successful bariatric surgery resulting in a weight loss of 114 lbs over 12 months. The diagnosis was confirmed using nerve conduction studies and electromyography. Clinical improvement occurred with decompressive surgery at the level of the knee.

Decompression, Surgical↗

PubMed1999

Peroneal neuropathy.

The clinical and electrodiagnostic presentation of peroneal neuropathies are detailed in this article. There is a special emphasis on nerve conduction study findings and their relationship to prognosis and management. The differential diagnosis of foot drop, including when caused by the anterior compartmental syndrome of the leg, is also discussed.

Anterior Compartment Syndrome↗

PubMed1981

Familial spastic paraplegia, peroneal neuropathy, and crural hypopigmentation: a new neurocutaneous syndrome.

A neurocutaneous syndrome is described in which spastic paraplegia, peroneal neuropathy, and crural hypopigmentation are inherited in a dominant pattern. Spastic paraplegia becomes clinically apparent during adolescence or in childhood and progresses slowly throughout the adult years with a variability in severity of expression. Peroneal neuropathy is documented clinically and by slowing on nerve conduction studies. Pattern-reversal visual evoked potentials also yield a delayed response, but brainstem auditory evoked potentials and somatosensory evoked potentials in upper and lower extremities are normal. Crural hypopigmentation is present in each neurologically affected family member. Although the pattern may vary, a pretibial distribution predominates. The lower-extremity abnormalities of the central and peripheral nervous system and neural crest cell derivatives may share a common relationship, but the abnormal visual evoked potentials suggest a more generalized involvement. This family may represent a transition form between familial spastic paraplegia and the spinocerebellar degenerations.

Adult↗

PubMed2005

MRI detection of cysts of the knee causing common peroneal neuropathy.

In 10 consecutive patients with footdrop due to common peroneal neuropathy without an obvious cause, MRI of the knee showed pathology at the fibular head in 6, including 5 patients with clinically unsuspected cysts of the tibiofibular joint. All 6 of the patients improved with surgery.

Adult↗

PubMed1996

Intrauterine onset of a mononeuropathy: peroneal neuropathy in a newborn with electromyographic findings at age one day compatible with prenatal onset.

Mononeuropathies are unusual at birth, and electromyographic (EMG) definition the first day of life has not been reported previously. Although neonatal mononeuropathies may be related to obstetric complications, prenatal mechanisms also merit consideration. We report an infant, born with a peroneal neuropathy, whose EMG was performed 18 h after birth. An isolated peroneal nerve lesion with lack of compound muscle action potential and the presence of fibrillation potentials, confined to the tibialis anterior muscle, suggested a primary intrauterine mechanism for this mononeuropathy. Because of an infant's small size, the temporal profile used in adults for appearance of EMG signs of wallerian degeneration may not apply. Inaccurate conclusions may result if the EMG standards for timing adult nerve injury are applied to newborns. To our knowledge, previous published cases of neonatal mononeuropathies have not included babies whose first EMG was performed before age 4 days. Therefore, an EMG study shortly after birth needed to be accomplished if strong support for the hypothesis of a prenatal onset were to be generated. Our findings are compatible with an intrauterine onset of this baby's peroneal neuropathy.

Electromyography↗

PubMed1992

Compressive bilateral peroneal neuropathy: serial electrophysiologic studies and pathophysiological remarks.

A case of bilateral common peroneal neuropathy following prolonged squatting is reported. Serial peroneal conduction velocities with analysis of compound muscle action potential (CMAP) amplitude, area and duration performed at Days 1, 2, 5, 7, 14, 21, 37, 80 showed conduction block localized at the fibular head which lasted 14 days and paralleled clinical conditions. Axonal loss coexisted as indicated by amplitude reduction of CMAP from peroneal nerve stimulation at the ankle which reached the lowest values at Day 7. Excessive temporal dispersion, as indicated by abnormal increased duration of the CMAP from stimulation above the fibular head, was never detected. Conduction velocity in the segment across the fibular head was reduced as long as conduction block was present, due to preferential block of large diameter, fast conducting, fibers. The rapid resolution of conduction block and the absence of temporal dispersion suggest that compressive conduction block is not necessarily due to demyelination. Mechanical factors or ischemic-metabolic mechanisms might play a role.

Adult↗

PubMedDate not supplied

Sensory potential can be preserved in severe common peroneal neuropathy.

Neuropathy of Common Peroneal Nerve (CPN) is a frequent clinical condition, generally caused by compression at the fibula head. Three neurophysiological patterns were described: 1) segmental demyelination with conduction block; 2) axonal damage with loss of motor units and sensory potential; 3) a mixed pattern. We report 5 patients with foot drop in whom CPN neuropathy was identified. In 3 in spite of impressive abnormalities in various motor branches and fascicles of the nerve, the peroneus nerve sensory potential remained well preserved. Focal neuropathies can be remarkably selective in terms of motor and sensory deficits, the reason can rely on a different location of the fibres or be related to a distinct histological-biochemical constitution. A preserved SPSP should not exclude a CPN neuropathy.

Action Potentials↗

PubMed1994

High sciatic lesion mimicking peroneal neuropathy at the fibular head.

We report 4 patients with severe, axon-loss, high sciatic mononeuropathies affecting exclusively the peroneal fibers: a boy with a slowly-growing nerve tumor, a woman with an injection injury, and 2 patients who had undergone proximal femur surgery. Clinically, the findings mimicked those seen with common peroneal neuropathy at the fibular head. The peroneal conduction studies were very low in amplitude/unelicitable. Conversely, the tibial studies and H-responses were normal in all; the sural responses were normal in one while low in amplitude/unelicitable in the remaining three. The biceps femoris, short-head, and all peroneal-innervated muscles showed fibrillations and profound motor unit loss. Conversely, the remaining hamstrings and all tibial-innervated muscles were normal. We conclude that a sciatic lesion can imitate a more distal peroneal lesion. Needle EMG of the biceps femoris, short head, is essential for correct diagnosis.

Action Potentials↗

PubMed2004

Compressive peroneal neuropathy during harvesting season in Indian farmers.

Thirty patients (34 limbs) with compressive peroneal neuropathy induced by prolonged squatting of more than 5 h during harvesting season were treated conservatively and followed-up to an average of 28.2 months. A marked preponderance of involvement of the left side was noticed. We attribute this to the intermittent extension of the right lower limb habitually used by Indian farmers to propel themselves forwards while squatting during harvesting. All but two lesions recovered fully within 3 to 9 weeks: one patient took 16 and another 20 weeks. We recommend non-operative treatment for this benign lesion.

Adolescent↗

PubMed2001

Focal cooling improves neuronal conduction in peroneal neuropathy at the fibular neck.

Heat can induce conduction block (CB) in demyelinated neurons; whether cooling can reverse CB and increase strength is uncertain. In six patients with electrophysiologic evidence of peroneal neuropathy at the fibular neck with definite motor CB, standard motor nerve conduction studies were performed at 32 degrees C and then after the fibular neck region was cooled with an ice pack to 8 degrees -12 degrees C. In all patients, cooling increased the amplitude and area of the compound motor action potential obtained with popliteal fossa stimulation, decreasing the relative amplitude drop across the fibular neck from a mean of 78% to 55%. A concomitant increase in foot dorsiflexor strength was clearly observed in three of the six patients. Both the electrophysiologic and clinical changes readily reversed upon rewarming. These data support the belief that, in compressive neuropathies, cooling relieves conduction block in selected motor neurons, improving strength.

Action Potentials↗

PubMed1992

[Compression-ischemic peroneal neuropathy].

The clinical picture is described of 4 patients with the syndrome of lesion of the peroneal developing during fixation of some physiological postures (squatting position etc.). The pathogenetic mechanisms of the disease are discussed. The authors report a characteristic monotypical clinical symptom complex of compression-ischemic peroneal neuropathy.

Acute Disease↗

PubMed2004

Peroneal neuropathy due to a popliteal aneurysm in a patient with infectious endocarditis.

We present an 18-year-old young man with the diagnosis of infective endocarditis who also suffered from concomitant knee pain. The clinical examination revealed right homonymous hemianopsia and left peroneal neuropathy. Magnetic resonance imaging studies of the knee demonstrated a lobulated saccular aneurysm in the left popliteal fossa. We diagnosed this patient as having peripheral mononeuropathy due to an aneurysm compressing the peroneal nerve in the left poplitea.

Adolescent↗