Multicenter study of peroneal mononeuropathy: clinical, neurophysiologic, and quality of life assessment

Abstract

This is a multicenter study on peroneal mononeuropathy (PM), in which a multidimensional protocol was performed to evaluate (1) the predisposing factors and their occurrence; (2) the relationships between the etiological, clinical, and neurophysiologic findings; and (3) disability and quality of life (QoL) in a wide sample with PM. Clinical and neurophysiologic evaluation was performed in all patients; moreover, the group adopted validated disability and QoL measurements to obtain more comprehensive and reliable data on PM. From November 2002 to January 2004, 69 patients were enrolled consecutively in 11 Italian centers. Our data showed that PM involves men more frequently than women (male : female = 4.1:1). PM was idiopathic (16%) or due to prolonged posture (23.1%), surgery (20.3%), weight loss (14.5%), trauma (11.6%), bedridden condition (7.3%), external compression from cast (5.8%), and arthrogenic cyst at the fibula (1.4%). Unexpectedly, peroneal nerve lesions were not only due to surgical operation close to the peroneal region but were also associated with thoracic-abdominal surgery. We observed conduction block in about 50-70% of postural and weight loss PM; in perioperative and idiopathic PM, conduction block or mixed damage was equally present; in PM due to trauma, we observed an exclusive axonal damage in about 60% of cases. Only in three cases (one postural PM, one idiopathic PM, and one weight loss PM), we observed a slowing of conduction velocity in the popliteal fossa-fibular head segment without conduction block. The comparison between QoL in patients with PM and in healthy subjects showed a significant involvement of physical and mental aspects. With regard to disability, 68% of patients walked with difficulty. Our data show that (1) most of the cases of PM are due to an identifiable predisposing factor; (2) there is a good correlation between predisposing factors and clinical-neurophysiologic findings; and (3) PM causes disability and deterioration of the physical and emotional aspects of QoL.

Quality of life among healthcare workers: A multicentre cross-sectional study in Italy

“…Even if a strong association between healthcare working and occupational stress has already been described by several Italian studies, how different categories of health care workers face the potential effect of healthcare working has not yet been fully explored [23][24][25][26][27].…”

Bilateral Peroneal Neuropathy after Obesity Surgery

“…Trauma, malignancies, infections, and defects of anatomical structures are the main etiologic causes of peroneal neuropathy (3). Weight loss is also accepted as a risk factor for peroneal neuropathies (2,4). Here, we present bilateral peroneal neuropathy as a complication of massive weight loss after obesity surgery.…”

“…Nutritional replacement, metabolic support, and dietary programs are important in treatment. Surgical therapy might be the second option in disabling cases, especially in patients with bilateral involvement (8). Our patient was referred to our hospital dietician.…”

“…Peroneal palsy commonly occurs due to compression or traction of the peroneal nerve around the fibular head and foot drop is the most common presentation of peroneal neuropathies (2). It may also be seen in a wide variety of other clinical conditions.…”

Functional outcome after peroneal nerve injury

“…Only one study was found describing walking disability and quality of life after peroneal nerve injury (Aprile et al, 2005). No studies exist describing restrictions in participation (WHO, 2001).…”