Sural neuropathy: Etiologies and predisposing factors

Abstract

Isolated sural neuropathy is an uncommon diagnosis. We identified 36 patients with isolated sural neuropathy. Sixteen had various forms of ankle trauma, in three of whom the associated sural neuropathies developed following medical intervention. Three patients developed sural neuropathy associated with vasculitis, and there were single patients with schwannoma and ganglionic cyst. In patients without a history of trauma, structural causes, such as schwannoma or ganglionic cysts and vasculitis, should be considered and managed as appropriate.

The sural nerve is not always a pure sensory nerve

“…We read with interest the article by Stickler et al 5 about etiologies and predisposing factors of sural nerve lesions. In their short anatomical review, the authors assume that the sural nerve is a purely sensory nerve.…”

Neurolymphomatosis and rare focal or multifocal lesions

“…In a series of 36 cases with isolated sural neuropathy, Stickler and colleagues reported 16 patients with ankle trauma, three with vasculitis, and one patient each with schwannoma and ganglionic cyst [8]. Ganglionic cysts of the sural nerve have also been described by other authors [10][11][12].…”

“…Schwannomas and other nerve sheath tumors rarely affect nerves used for diagnostic biopsy in an isolated manner [8]. In contrast, involvement of such nerves by socalled schwannoid tumorlets is common in neuropathies in the context of neurofibromatosis-2 (see Chapter 23).…”

A modified straight leg raise test to differentiate between sural nerve pathology and Achilles tendinopathy. A cross-sectional cadaver study

“…Sural nerve pathology is an uncommon diagnosis (Stickler et al, 2006), but is a condition that may be overlooked as differential diagnosis. For example, a retrospective analysis of 18 elite athletes with suspected chronic Achilles tendinopathy who failed conservative tendon management revealed that sural nerve entrapment was the cause of the symptoms (Fabre et al, 2000).…”