Bilateral Peroneal Nerve Palsy Research Articles

Bilateral Peroneal Nerve Palsy in a Floor Tile Worker Flowing Prolonged Squatting

Bilateral Peroneal Nerve Palsy in a Floor Tile Worker Flowing Prolonged Squatting

Bilateral peroneal nerve palsy due to prolonged squatting in farmers: clinical and electrophysiological outcome

ABSTRACT Introduction Peroneal neuropathy is the most common mononeuropathy of the lower extremities. However, bilateral peroneal nerve palsy (BPNP) is extremely rare due to prolonged squatting. We aimed to evaluate the clinical-electrophysiological findings in patients with BPNP caused by long-term squatting for cotton harvesting in our region. Methods Eight patients (16 limbs), admitted to our center between February 2018 and March 2021 with bilateral foot drop after prolonged squatting, were included in our study. The clinical and electrophysiological findings were re-evaluated six months later. Results We observed that 18.75% of the limbs had pure conduction block, 31.25% had mixed involvement, and half had predominantly axonal damage. Good recovery was observed in ankle dorsiflexion in seven patients during follow-ups. None of the patients were referred for surgery. Electrophysiological examinations showed that the conduction block was resolved, and reinnervation was observed in all patients with axonal degeneration. Conclusion Since the etiology is nontraumatic compression, good recovery can be seen with conservative treatment in BPNP. Electrophysiological studies may determine reinnervation along with clinical examination. The patient should be followed-up for six months with conservative treatment before surgical intervention.

Squatting-induced bilateral peroneal nerve palsy in a sewer pipe worker

Compression neuropathy of the common peroneal nerve (CPN) at the fibula head is a common condition, but it has not attracted attention in working environments. Here, we report a 38-year-old sewer pipe worker who presented with bilateral CPN palsy following 6h working with a squatting posture in a narrow sewer pipe. During the work, he could not stretch his legs sufficiently because of the confined space. His symptoms deteriorated with repetition of the same work for 1 week. Motor nerve conduction study showed conduction block at the fibula head of bilateral CPNs, compatible with compression neuropathy at this lesion. Three months after cessation of work requiring the causative posture, his symptoms and neurophysiological abnormalities had resolved completely. Almost all seven of his co-workers presented transiently with similar and milder symptoms, although one showed CPN palsy for 6 months. Prolonged squatting posture in a confined space causes acute compression neuropathy at the fibula head in the CPN. More attention should be paid to 'confined space worker's compression neuropathy'.

Physical Therapy for an Elderly Patient with Pelvic Fracture Complicated by Bilateral Peroneal Nerve Palsy

Physical Therapy for an Elderly Patient with Pelvic Fracture Complicated by Bilateral Peroneal Nerve Palsy

An Uncommon Case of Bilateral Peroneal Nerve Palsy following Delivery: A Case Report and Review of the Literature.

Peroneal nerve palsy is an infrequent but potential complication of childbirth. Bilateral peroneal palsy is particularly rare following delivery with few reported cases. A 38-year-old gravida 1, para 0 underwent a prolonged second stage of labor, was diagnosed with an arrest of descent, and subsequently underwent an uncomplicated primary cesarean section. The patient was diagnosed with bilateral peroneal neuropathy four days after delivery. By two months postpartum, her foot drop had improved by 85% and the remainder of her symptoms resolved. Awareness of the risks of a peroneal neuropathy as well as implementation of preventive measures is important for members of the delivery team. Regional anesthesia during labor is a risk factor for the development of a peroneal neuropathy.

Early Results of the Bernese Periacetabular Osteotomy for Symptomatic Dysplasia in Charcot-Marie-Tooth Disease

Charcot-Marie-Tooth disease (CMTD) is one of the most common inherited neurologic disorders and can be associated with hip dysplasia. Little is known regarding outcomes of the PAO for patients with CMTD. Our purpose is to document the early results and complications of the PAO for hip dysplasia associated with CMTD. A two centre, retrospective clinical and radiographic review was performed. Demographic and surgical data were recorded. Pre- and postoperative lateral centre edge angle (LCEA), acetabular index (AI), ventral centre edge angle (VCEA), and Tönnis osteoarthritis grade were compared. Hips were classified according to Severin. The Harris Hip Score (HHS) and the Western Ontario and McMasters University (WOMAC) index documented self-reported function. Nineteen hips in 14 patients underwent PAO, mean age 16.2 (range 11.2-21 years). Thirteen concomitant procedures were performed, including seven proximal femoral osteotomies. Average follow-up was 3.4 years (range 0.9-8.5). Postoperative radiographic measurements significantly improved. Complications included femoral head AVN, transient complete bilateral peroneal nerve palsy, inferior rami fractures, and heterotopic ossification (Brooker stage 3). The HHS significantly improved from a mean 49.6 preoperatively to 82.2 at final follow-up of four patients. Seven subjects reported a mean postoperative WOMAC score of 94 (range 58.3-100). Most patients presented with severe dysplasia in the second decade of life. The PAO successfully corrected the radiographic abnormalities. Complications were common. The majority of patients reported improved outcomes, although seven showed signs of radiographic progression of osteoarthritis.

Bilateral Peroneal Nerve Palsy After Bilateral Hip Osteotomy in a Patient with Multiple Hereditary Exostosis: A Case Report and Review of the Literature.

Osteochondromas are solitary masses that rarely cause pain or other symptoms. However, in cases of multiple hereditary exostoses (MHE) in which many osteochondromas are present, extremity deformity is more common. Surgical excision is considered in situations in which altered bone growth is affecting function or if the osteochondroma causes pain. Osteochondromas that affect the proximal part of the femur are common, reported to be involved in 30% to 90% of cases of MHE1-4, and can affect growth and morphology of both the femur and acetabulum. More specifically, coxa valga deformities have been reported in 25% of patients with MHE5, including femoral neck broadening, femoral anteversion, and valgus deformity together with acetabular dysplasia4,6. Proximal femoral varus-producing osteotomies have been described7. To the best of our knowledge, there have been no reported nerve injuries during a varus-correcting osteotomy of the proximal part of the femur in patients with MHE. However, one report of 164 proximal femoral osteotomies not associated with MHE described peroneal nerve palsies in two patients8. In this report, we examine the case of a young boy treated for proximal femoral valgus deformity in MHE with bilateral varus-producing osteotomy of the proximal part of the femur. We evaluate the surgical complication of bilateral peroneal nerve palsy and discuss the patient’s clinical course, including surgical treatment of the nerve palsies. The patient and his parents were informed that his case would be submitted for publication, and they provided consent. A nine-year-old boy with multiple previous surgical interventions related to MHE had been followed for painful bilateral hip dysplasia and valgus deformity of the proximal part of the femur. The patient had no additional symptoms regarding the lower extremities, and the physical examination demonstrated excellent strength and normal sensation. …

Bilateral Peroneal Nerve Palsy Following Squatting

Bilateral Peroneal Nerve Palsy Following Squatting

Bilateral Peroneal Nerve Palsy Following Squatting

Bilateral Peroneal Nerve Palsy Following Squatting

Bilateral Peroneal Nerve Palsy Caused by Intermittent Pneumatic Compression

A 63-year-old man developed bilateral peroneal nerve palsies after a craniotomy for a craniopharyngioma. It is believed that the primary etiology of the nerve palsies was intermittent pneumatic compression, which was used to prevent deep vein thrombosis and pulmonary embolism during the surgery. Physicians should take care to avoid compressing the fibula head when using pneumatic devices.

Hereditary neuropathy with liability to pressure palsies in infancy

Hereditary neuropathy with liability to pressure palsies is an autosomal-dominant disorder, classically characterized by recurrent mononeuropathies, associated with a deletion at 17p11.2, encompassing the peripheral myelin protein 22 gene. The typical clinical episodes of pressure palsy are usually noted for the first time during the 2nd or 3rd decade of life. We found only few reports in prepubertal children. We report a case of a 7.5-year-old child with muscle weakness and severe hypotonia associated with developmental gross motor delay. We suspect that bilateral peroneal nerve palsies after birth were the first episode of pressure palsy. Nerve conduction studies demonstrated slightly prolonged distal latencies with normal conduction velocity. Typical features of hereditary neuropathy with liability to pressure palsies with recurrent mononeuropathies were found in the father. DNA analysis revealed 1.5-Mb deletion at 17p11.2 in both father and child. To the best of our knowledge, this patient is one of the youngest ever found with this disease.

Bilateral peroneal nerve palsy after simultaneous bilateral total knee arthroplasty. Report of a case with rheumatoid arthritis.

In this study, we report on a 46-year-old female patient with bilateral severe gonarthrosis due to rheumatoid arthritis. Simultaneous bilateral cemented total knee arthroplasty was performed. Bilateral common peroneal nerve palsy was observed on the second postoperative day. The electromyographic diagnosis was "bilateral axonotmesis". Complete clinical and electromyographic motor recoveries were seen on both sides within 6 months postoperatively. The sensorial deficit was still present on one side at 2 years postoperatively. Preoperative severe flexion contracture and epidural anesthesia were assumed as the risk factors for the development of the nerve palsy in this patient.

Bilateral Peroneal Nerve Palsy Induced by Prolonged Squatting

External or internal pressures on peripheral nerves may result in compression neuropathies. Although compressive common peroneal nerve palsy is well known, to date very few cases with bilateral palsies have been reported. The clinical and electrophysiological manifestations of three patients with bilateral peroneal nerve palsies are reported, and their clinical outcomes are discussed. The first patient's transient bilateral palsy was corrected by conservative means. The second patient, with a more severe axonal lesion, did not improve within 3 months, and nearly complete recovery occurred after operative decompression. For the third patient, who had been suffering for a long time, no improvement could be hoped for. Prolonged squatting was the etiological factor in all three cases. Bilateral compression neuropathies of the peroneal nerve, like unilateral lesions, may recover spontaneously. Surgical intervention is recommended for patients with predominantly axonal lesions and for those who do not improve within 3 months.

Anorexia nervosa presenting as foot drop

A patient with anorexia nervosa is reported whose presentation with foot drop was to a neurological department. Bilateral peroneal nerve palsies were subsequently demonstrated. The aetiology of these transient palsies is discussed.

NEUROPATHY, AGRANULOCYTOSIS, AND HEPATO-TOXICITY FOLLOWING IMIPRAMINE THERAPY

Bilateral peroneal nerve palsy, agranulocytosis, and hepato-toxicity following imipramine administration, with improvement after cessation of the drug, were observed. Laboratory tests seemed to rule out other possible sources of the symptoms noted. The 5 previously reported cases of motor neuropathy appearing during imipramine therapy are similar in that they all involved elderly persons, and were restricted to the lower extremities. Complete remission of neurologic symptoms is not universal. Considering recent experience with thalidomide, the large variety of neurotoxic side effects seen with imipramine would merit caution in the use of this agent in pregnancy.