Bulgarian Neurology
Published November 30, 2024 | Version v1
Journal article Open

Differential diagnosis of peroneal nerve palsy – case presentation

Authors/Creators

  • 1. ROR icon Multiprofile Hospital for Active Treatment in Neurology and Psychiatry St. Naum
  • 2. ROR icon Medical University of Sofia
  • 3. National Genetic Laboratory
  • 4. University Hospital of Obstetrics and Gynecology, National Genetic Laboratory

Description

Peroneal nerve palsy is the most common form of compression neuropathy of the lower limb, presenting with limited dorsal flexion of the foot with or without sensory symptoms. The etiology is variable, with nerve compression being the leading cause. The most common cases of peroneal palsy happen after trauma, surgical interventions in the foot and knee area, as well as compression of the nerve after prolonged lying of the patient in one posture, after immobilization, or after prolonged kneeling or staying with crossed legs, especially after significant weight loss. Peroneal nerve palsy is seen in various polyneuropathies, with peroneal paresis being one of the most common initial presentations in hereditary neuropathy with pressure palsies (HNPP).
We present the cases of patients, that illustrate the different etiologies of peroneal nerve palsy – a case of a girl with peroneal paresis after trauma of the foot, a case of a boy with peroneal paresis after prolonged lying in one posture, leading to a compression of the nerve and a case of peroneal palsy in a girl with significant weight loss. In the last case, the positive family history, the slow improvement in the clinical picture, as well as the results of the electrophysiological study, which showed involvement of other nerves during the acute onset of the peroneal monoparesis, were suggestive for the diagnosis of HNPP.

Abstract (Bulgarian)

Перонеалната пареза е най-честата форма на компресионна невропатия на долен крайник, като протича с ограничена дорзална флексия на ходилото със или без сетивна симптоматика. Етиологията е разнообразна, като притискането на нерва има водещо значение. Най-чести са случаите на перонеална пареза след травма, оперативни интервенции в областта на ходилото и коляното, вкл. след продължително залежаване на пациента в една поза, след поставяне на имобилизиращи шини, при продължително стоене на колене или с кръстосани крака, особено при значителна загуба на тегло. Засягане на n. peroneus се наблюдава при различни полиневропатии, като перонеалната пареза е една от най-честите първоначални изяви при наследствена невропатия със склонност към парализи при притискане (ННПП).
В статията са описани случаи на пациенти, илюстриращи различни етиологични причини за възникване на перонеална пареза – случай на момиче с перонеална пареза след травма в областта на ходилото, случай на момче с перонеална пареза след залежаване, водещо до продължително пристискане на нерва, както и случай на притискане на нерва при прекръстосване на краката при момиче със значителна загуба на телесно тегло. При последния случай насочващи за диагнозата ННПП са положителната фамилна анамнеза, отчетеното бавно подобрение в клиничната картина, както и резултатите от електрофизиологичното изследване, което показва засягане на други нерви при остро възникнала монопареза.

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Additional details

Additional titles

Translated title (Bulgarian)
Диференциална диагноза при перонеална пареза – представяне на клинични случаи

Identifiers

ARK
ark:/53357/NEU.v25i2.174
URL
https://www.nevrologiabg.com/journal/index.php/neurology/article/view/174
ISSN
2815-2522

Dates

Issued
2024-11-30

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