1/55. Total innervation of the extensor digitorum brevis by the accessory deep peroneal nerve. We describe a patient with complete (100%) innervation of the extensor digitorum brevis muscle by the accessory deep peroneal nerve, which resulted in an erroneous diagnosis of peroneal mononeuropathy. ( info) |
| Synovial or ganglion cysts of the proximal tibiofibular joint are less common than synovial cysts of the knee joint but may present in a similar manner and may be difficult to diagnose clinically. Although synovial cysts arising from the knee joint after prosthetic arthroplasty have already been described, we report a case in which a lateral knee mass compressing the peroneal nerve was found to be a synovial cyst arising from the tibiofibular joint. ( info) |
| We report the case of a 43-year-old woman who underwent knee arthroscopy. Postoperatively, she developed a lesion of the common peroneal nerve, which was confirmed by neurophysiological studies. Exploration showed the nerve to be in continuity and externally undamaged. At review 17 months later, there was incomplete recovery. We believe this lesion was caused by a traction injury related to patient positioning, which has not been reported previously. ( info) |
4/55. Evoked spinal cord potential monitoring reveals peroneal nerve ischemia during thoracoabdominal repair: a case report. An 82-year-old man underwent thoracoabdominal aortic replacement under cardiopulmonary bypass with left femoral artery cannulation. Lumber descending evoked spinal cord potentials and segmental evoked spinal cord potentials were monitored simultaneously for detecting spinal cord damage. When the cardiopulmonary bypass was terminated, a peripheral nerve ischemia pattern was evident. Left peroneal nerve paralysis was present at emergence from anesthesia. This monitoring system revealed that peroneal nerve paralysis can occur due to leg ischemia caused by femoral artery cannulation. This is, to our knowledge, the first report that segmental evoked spinal cord potential monitoring reveals peroneal nerve ischemia during thoracoabdominal surgery. ( info) |
5/55. Bilateral peroneal nerve palsy induced by prolonged squatting. External or internal pressures on peripheral nerves may result in compression neuropathies. Although compressive common peroneal nerve palsy is well known, to date very few cases with bilateral palsies have been reported. The clinical and electrophysiological manifestations of three patients with bilateral peroneal nerve palsies are reported, and their clinical outcomes are discussed. The first patient's transient bilateral palsy was corrected by conservative means. The second patient, with a more severe axonal lesion, did not improve within 3 months, and nearly complete recovery occurred after operative decompression. For the third patient, who had been suffering for a long time, no improvement could be hoped for. Prolonged squatting was the etiological factor in all three cases. Bilateral compression neuropathies of the peroneal nerve, like unilateral lesions, may recover spontaneously. Surgical intervention is recommended for patients with predominantly axonal lesions and for those who do not improve within 3 months. ( info) |
6/55. Intrapartum common peroneal nerve compression resulted in foot drop: a case report. This case report is to illustrate a case of a 24-year-old Jordanian woman, gravida 1, para 0 who developed intrapartum foot drop due to compression injury of the common peroneal nerve behind the head of fibula. diagnosis was based on history, clinical examination and electrophysiological studies. Treatment included daily sessions of physiotherapy. Complete recovery of the condition took place within 2 months. ( info) |
7/55. 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. ( info) |
8/55. MRI in unexplained mononeuropathy. Four young patients with severe unexplained progressive mononeuropathy are described. None had a history of known trauma to the affected limb. In addition to the standard neurologic examination and electrophysiologic studies (nerve conduction studies and electromyography), all underwent neuroimaging of the involved extremity. In three patients, magnetic resonance imaging revealed intrinsic abnormalities of the appropriate nerve. The pattern or absence of magnetic resonance imaging changes directly influenced decisions about surgical exploration of the nerve in all four patients. With the advent of more sophisticated technology, magnetic resonance neurography has become a potent diagnostic tool in the evaluation of disorders of peripheral nerve and muscle. ( info) |
9/55. Bilateral peroneal nerve injuries in a patient with bilateral femur fractures: a case report. The second reported case in the current literature of peroneal nerve palsy in bilateral femur fractures is described. This is the first case report of bilateral nerve palsies occurring in bilateral femoral fractures and the first report of bilateral peroneal nerve palsy associated with bilateral skeletal traction. ( info) |
10/55. 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. ( info) |