Clinical Characteristics of Peroneal Nerve Palsy by Posture

Abstract

ObjectivePosture induced common peroneal nerve (CPN) palsy is usually produced during the prolonged squatting or habitual leg crossing while seated, especially in Asian culture and is manifested by the onset of foot drop. Because of its similarity to discogenic foot drop, patients may be diagnosed with a lumbar disc disorder, and in some patients, surgeons may perform unnecessary examinations and even spine surgery. The purpose of our study is to establish the clinical characteristics and diagnostic assessment of posture induced CPN palsy.MethodsFrom June 2008 to June 2012, a retrospective study was performed on 26 patients diagnosed with peroneal nerve palsy in neurophysiologic study among patients experiencing foot drop after maintaining a certain posture for a long time.ResultsThe inducing postures were squatting (14 patients), sitting cross-legged (6 patients), lying down (4 patients), walking and driving. The mean prolonged neural injury time was 124.2 minutes. The most common clinical presentation was foot drop and the most affected sensory area was dorsum of the foot with tingling sensation (14 patients), numbness (8 patients), and burning sensation (4 patients). The clinical improvement began after a mean 6 weeks, which is not related to neural injury times. Electrophysiology evaluation was performed after 2 weeks later and showed delayed CPN nerve conduction study (NCS) in 24 patients and deep peroneal nerve in 2 patients.ConclusionWe suggest that an awareness of these clinical characteristics and diagnostic assessment methods may help clinicians make a diagnosis of posture induced CPN palsy and preclude unnecessary studies or inappropriate treatment in foot drop patients.

Post-bariatric surgery peripheral neuropathies: Kuwaiti experience

“…This higher occurrence of peroneal palsy in our patients is likely due to cultural differences. In Asia, squatting or sitting "taylor" style with legs crossed is quite common, causing peroneal nerve compromise [27]. Peroneal palsy, especially bilateral, is disabling [28] while entirely preventable by avoiding the offending postures.…”

Anatomical Variants of “Short Head of Biceps Femoris Muscle” Associated with Common Peroneal Neuropathy in Korean Populations : An MRI Based Study

“…Posture-induced common peroneal neuropathy (CPNe) is a clinical presentation caused by a prolonged body position that leads to acute foot drop with sensory disturbances of the anterior or lateral compartments of lower leg. We previously reported the clinical characteristics of posture-induced CPNe and summarized eight helpful diagnostic points for differential diagnosis [ 11 ]. In Asians, kneeling and squatting are the postures that are most often induce CPNe.…”

Unusual variant of distal biceps femoris muscle associated with common peroneal entrapment neuropathy

“…The kneeling and squatting postures most often induced CPNe in Asians. [ 10 ] However, the authors could not define a possible compression site of the CPN during hyper-flexion of knees, except for the fibular tunnel. Also, Masakado et al [ 6 ] mentioned fibular tunnel, as a compression site of the CPN when knee was hyper-flexed, but could not describe the mechanism for entrapment of CPN.…”