Clinical Neurophysiology in the Diagnosis of Peroneal Nerve Palsy

Abstract

Peroneal neuropathy is one of the common focal mononeuropathies in the lower extremities occurring in both adults and children. Foot drop due to weakness of ankle dorsiflexion is the most common presentation of a peroneal neuropathy. It may also result from other causes involving the upper or lower motor neurons. Disorders that must be distinguished from peroneal neuropathy include sciatic mononeuropathy, lumbosacral plexopathy, motor neuron disease, polyneuropathy, and an L5 radiculopathy. To establish a diagnosis, electrodiagnostic studies have been used to localize the level of the abnormality and to establish prognosis. The most common site of injury is the fibular head, but focal neuropathies have also been reported at the level of the calf, ankle, and foot. In this article, we overviewed the peroneal nerve palsy, and its diagnosis by neurophysiologic evaluation, conduction study and needle EMG. The neurophysiologic information gives us the underlying pathophysiology and its prognosis. Therefore the neurophysiologic evaluation must be performed not only for the differential diagnosis, but also for planning the treatment strategy.

Manual therapy and neurodynamic mobilization in a patient with peroneal nerve paralysis: a case report

“…1 The condition involves the muscles of foot dorsiflexion (tibialis anterior, extensor hallucis longus, and extensor digitorum longus) and the nerves that supply them, primarily the common peroneal nerve. Common causes of drop foot include compartment syndrome, diabetes, stroke, lumbar disk protrusions, musculoskeletal compression, myopathies, neuropathies, and peripheral nerve injuries [2][3][4] and corresponding steppage gaitalso known as drop-foot gait. 5 Peroneal nerve paralysis (PNP) is the most common mononeuropathy in the lower limb, and it is vulnerable to damage around the fibular head because of the anatomical position between the peroneal nerve and fibula.…”

Common peroneal nerve palsy caused by an initially misdiagnosed extraneural and intraneural benign ganglion cyst of the peroneal nerve in a 11-year-old child: A rare but severe condition

“…The prognosis of functional recovery in patients with CPN palsy depends on the severity of neurological deficit and time of surgical neurolysis. In general, the prognosis for a demyelinating lesion is much more favorable than for an axonal loss lesion [13]. The outcome is usually favorable if surgery is done within four months after first presentation of neurological deficits, and less favorable in patients who have neurological symptoms for longer than one year [1,14].…”

Diagnostic pitfalls in spine surgery: masqueraders of surgical spine disease

“…Lumbosacral plexopathies, sciatic neuropathies, and peroneal nerve palsies can all present with weakness of ankle dorsiflexion and a steppage gait. 41 Because the peroneal nerve arises from fibers of the L-4, L-5, and S-1 nerve roots, radiculopathy affecting these roots necessarily also affects the peroneal nerve. There are a number of important differences on motor and sensory examination.…”