The diagnostic significance of superficial peroneal nerve and peroneus brevis muscle biopsy: a clinicopathological report of 15 cases

Abstract

Objective In an attempt to clarify the usefulness of combined nerve and muscle biopsy in the diagnosis of neuromuscular disease when compared with traditional sural nerve biopsy. Methods Fifteen biopsies of superficial peroneal nerve (SPN) and peroneus brevis muscle（PBM) by one incision performed within one neurological clinic were reviewed. All patients had peripheral neuropathy while 3 of them had myopathy clinically. The diagnostic significance of SPN and PBM biopsies were classified into 3 grade: essential，helpful，no value. Results Of 15 SPN and PBM biopsies, 7 showed essential pathological findings which reached the etiological diagnosis, including 5 definite vasculitis, 1 inflammatory demyelinating polyneuropathy and 1 amyloid neuropathy. Five biopsies are helpful for etiological diagnosis, including demyelinating neuropathy, mild inflammation, and microvascular lesion, et al. Three biopsies are of no value for etiological diagnosis which only have nonspecific change such as type 2 fiber atrophy, neurogenic atrophy and axonal degeneration et al. Finally, SPN and PBM biopsies made the definite etiological diagnosis possible in 12 patients. Conclusions SPN and PBM biopsy improved the yield of specific pathological and etiological diagnosis of neuropathy and myopathy such as vasculitis and amyloidosis with minor trauma and side effect. Further clinical and pathological studies will be necessary for a better practice of combined nerve and muscle biopsy. Key words: Peroneal nerve; Muscle; skeletal; Biopsy; Peripheral nervous system diseases