Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy

Matsumoto, Juntaro; Isu, Toyohiko; Kim, Kyongsong; Iwamoto, Naotaka; Yamazaki, Kazuyoshi; Isobe, Masanori

doi:10.2176/nmc.oa.2018-0039

Cited by 23 publications

(33 citation statements)

References 11 publications

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“…SPN innervates the fibularis longus and brevis muscles, the skin on the lateral side of the calf, lateral part of the ankle, and the dorsum of the foot. During nerve damage, the patient cannot lift the lateral edge of the foot, the foot is turned in (supinated) and they step on the fibular edge of the foot [5]. Nerve impairment is also associated with pain syndrome in the innervated area of the skin.…”

Section: материал и методыmentioning

confidence: 99%

“…Затруднения в диагностике также обусловлены топографическими вариантами прохождения нерва, описанными в литературе [3,5]. Часто встречаются разнообразные неврологические проявления, связанные с различным распределением сенсорных волокон нерва.…”

Section: результаты и обсуждениеunclassified

“…SPN descends on the lateral compartment of the calf, where it innervates the peroneus longus and brevis muscles, which evert the foot and provide sensitive innervation of the distal lateral part of the calf. Approximately 5-12 cm above the ankle, it exits the fascia subcutaneously, where it divides into 2 terminal branches -the intermediate dorsal cutaneous nerve and the medial dorsal cutaneous nerve [1,5]. The compression could be external, e. g. compression of a superficially located nerve on a bone, or https://doi.org/10.15360/1813-9779-2021-2-00-00 Clinical Studies and Practice Примерно в 5-12 см над лодыжкой ПМН выходит из фасции под кожу, где разделяется на 2 терминальные ветви, которые называются промежуточный и медиальный дорзальные подкожные нервы [1,5].…”

Section: Introductionunclassified

“…Approximately 5-12 cm above the ankle, it exits the fascia subcutaneously, where it divides into 2 terminal branches -the intermediate dorsal cutaneous nerve and the medial dorsal cutaneous nerve [1,5]. The compression could be external, e. g. compression of a superficially located nerve on a bone, or https://doi.org/10.15360/1813-9779-2021-2-00-00 Clinical Studies and Practice Примерно в 5-12 см над лодыжкой ПМН выходит из фасции под кожу, где разделяется на 2 терминальные ветви, которые называются промежуточный и медиальный дорзальные подкожные нервы [1,5]. Сдавление нерва может происходить извне (например, при прижатии поверхностной части нерва к кости) или изнутри (в месте физиологического сужения) [1].…”

Section: Introductionunclassified

“…ПМН иннервирует длинную и короткую малоберцовые мышцы, кожу на латеральной стороне икры, латеральной части лодыжки и тыл стопы. При повреждении нерва пациент теряет способность к поднятию латерального края стопы, которая приобретает супинированное положение, в результате чего пациент может наступать лишь на малоберцовый ее край [5]. При поражении нерва в зоне кожной иннервации развивается болевой синдром.…”

Section: Introductionunclassified

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Elusive Diagnosis of Superﬁcial Peroneal Nerve Entrapment Case report

Rapčan¹,

Kočan²,

Alfredson³

et al. 2021

Obŝaâ reanimatologiâ

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Isolated neuropathy of the superficial peroneal nerve (SPN) is a relatively rare type of peripheral neuropathy. It is linked to the mechanical entrapment of the SPN in predisposed locations of its anatomical pathway. Associated clinical findings are insufficient lifting of the latero-dorsal part of the foot, stepping on the lateral border of the foot, and commonly, a strong pain localized in the nerve dermatome.Case report. We describe a case of a 14-year-old female patient with right leg pain lasting 24 months. Repeated neurological examinations with negative findings on electromyography (EMG) were performed. The patient underwent a Steindler surgery for a suspected diagnosis of a heel spur, without any improvement. Despite complex pharmacotherapy, chronic pain developed. The patient was unable to walk, being bound to a wheelchair. Amputation of her lower limb under the knee was also considered. SPN entrapment was diagnosed at a physical examination at EuroPainClinics. Decompression of the SPN under local anaesthesia was performed at the clinic.Results. The symptoms improved immediately after the procedure, and following 2 months of rehabilitation, the patient was completely symptom-free. Her clinical state remains unchanged until this day.Conclusions. SPN entrapment is not a common diagnosis in the group of pain syndromes. Regarding the lower limb, it is imperative to include it on the list of differential diagnoses in cases of pain and functional disorders of the lateral muscle groups of the calf and leg. In the case of SPN entrapment, EMG findings may be negative.

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Section: материал и методыmentioning

confidence: 99%

Section: результаты и обсуждениеunclassified

Section: Introductionunclassified

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Elusive Diagnosis of Superﬁcial Peroneal Nerve Entrapment Case report

Rapčan¹,

Kočan²,

Alfredson³

et al. 2021

Obŝaâ reanimatologiâ

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Characterization of mononeuropathy of the lateral cutaneous nerve of the calf

2021

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Introduction/Aims: Isolated injuries to the lateral cutaneous nerve of the calf (LCNC) branch of the common peroneal nerve can cause obscure chronic posterolateral knee and upper calf pain and sensory symptoms. Routine examination and electrodiagnostic testing do not detect them because the LCNC has no motor distribution and it is not interrogated by the typical peroneal nerve conduction study. There are only about 10 prior cases, thus scant physician awareness, so most LCNC injuries remain misdiagnosed or undiagnosed, hindering care.Methods: We extracted pertinent records from seven patients with unexplained posterolateral knee/calf pain, six labeled as complex regional pain syndrome, to investigate for mononeuropathies. Patients were asked to outline their skin area with abnormal responses to pin self-examination independently. Three underwent an LCNC-specific electrodiagnostic study, and two had skin-biopsy epidermal innervation measured. Cadaver dissection of the posterior knee nerves helped identify potential entrapment sites.Results: Initiating events included knee surgery (three), bracing (one), extensive kneeling (one), and other knee trauma. All pin-outlines included the published LCNC neurotome. One oftwo LCNC-specific electrodiagnostic studies revealed unilaterally absent potentials. Longitudinal, controlled skin biopsies documented profound LCNC-neurotome denervation then re-innervation contemporaneous with symptom recovery. Cadaver dissection identified the LCNC traversing through the dense fascia of the proximolateral gastrocnemius muscle insertion.Discussion: Isolated LCNC mononeuropathy can cause unexplained posterolateral knee/calf pain syndromes. This series characterizes presentations and supports patient pin-mappings as a sensitive, globally available, low-cost diagnostic aid.Improved recognition may facilitate more rapid, accurate diagnosis and, thus, optimize management and improve outcomes.

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Superficial Peroneal Nerve Dysfunction

Charalambous

2021

The Knee Made Easy

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Clinical Features and Surgical Treatment of Superficial Peroneal Nerve Entrapment Neuropathy

Cited by 23 publications

References 11 publications

Elusive Diagnosis of Superﬁcial Peroneal Nerve Entrapment Case report

Elusive Diagnosis of Superﬁcial Peroneal Nerve Entrapment Case report

Characterization of mononeuropathy of the lateral cutaneous nerve of the calf

Superficial Peroneal Nerve Dysfunction

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