Abstract
BackgroundCommon peroneal mononeuropathy at the fibular neck (CPN) is one of the most frequent neuropathies of the lower extremities. Nerve conduction studies (NCS) have been used to confirm the diagnosis of CPN and localize common peroneal nerve abnormalities. High-resolution ultrasonography (HRUS) can aid in assessing the size of the common peroneal nerve.AimWas to evaluate the superficial peroneal sensory potential (SPSP) and HRUS role in the confirmation of CPN.MethodsThis study was conducted on 70 patients presented with clinical and motor electrophysiological evidence of common peroneal neuropathy at the fibular neck and 70 controls. Clinical assessment, electrophysiological evaluations, and HRUS at the fibular neck were done.ResultsAll the patients were electrophysiologically proven to have common peroneal motor neuropathy at the fibular neck, and seven of them showed abnormalities in nerve conduction studies only. The patients showed smaller common peroneal nerve motor and sensory responses and much larger cross-sectional area (CSA) of the common peroneal nerve at the fibular neck when compared with the controls. NCS and EMG positive findings are the most significant factor related to the increased HRUS CSA. Affected SPSP is significantly detected in patients with axonal affection. CSA of common peroneal nerve at the fibular neck showed a significant positive correlation with body mass index, motor, and sensory latencies. Also, it showed a significant negative correlation with motor and sensory amplitudes. HRUS CSA localized the lesion at the fibular neck with sensitivity and specificity 83% and 53% respectively. CSA plus SPSP affection sensitivity and specificity in confirming CPN were 91.9% and 89%.ConclusionHRUS CSA plus affected SPSP improve the diagnosis of CPN compared to standard electrophysiological criteria.RecommendationFurther studies on a wider scale for detection of their role in the prediction of prognosis in CPN.Trial registrationClinicalTrials.gov NCT03753178 (26-11-2018)
Highlights
Common peroneal mononeuropathy at the fibular neck (CPN) is one of the most frequent neuropathies of the lower extremities
The patients showed smaller common peroneal nerve motor and sensory responses and much larger cross-sectional area (CSA) of the common peroneal nerve at the fibular neck when compared with the controls
Nerve conduction studies (NCS) and Electromyographic study (EMG) positive findings are the most significant factor related to the increased High-resolution ultrasonography (HRUS) CSA
Summary
Common peroneal mononeuropathy at the fibular neck (CPN) is one of the most frequent neuropathies of the lower extremities. Common peroneal mononeuropathy at the fibular neck (CPN) is one of the most frequent mononeuropathies of the lower extremities. Risk factors for compression of the common peroneal nerve at the fibular neck are repetitive trauma, habitual prolonged leg crossing, patients at bed rest, poor positioning during surgery, marked weight loss, diabetes mellitus, high ankle sprain, fracture of the proximal fibula, and anatomic variants. The clinical and electrodiagnostic findings in CPN resemble the anatomical structure of the common peroneal nerve, and fibers for the deep peroneal nerve and the superficial peroneal nerve are bounded in separate fascicles along the course of the nerve [4]
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