Elusive Diagnosis of Superficial Peroneal Nerve Entrapment Case report
https://doi.org/10.15360/1813-9779-2021-2-00-00
Abstract
Isolated neuropathy of the superficial peroneal nerve (SPN) is a relatively rare type of peripheral neuropathy. It is linked to the mechanical entrapment of the SPN in predisposed locations of its anatomical pathway. Associated clinical findings are insufficient lifting of the latero-dorsal part of the foot, stepping on the lateral border of the foot, and commonly, a strong pain localized in the nerve dermatome.
Case report. We describe a case of a 14-year-old female patient with right leg pain lasting 24 months. Repeated neurological examinations with negative findings on electromyography (EMG) were performed. The patient underwent a Steindler surgery for a suspected diagnosis of a heel spur, without any improvement. Despite complex pharmacotherapy, chronic pain developed. The patient was unable to walk, being bound to a wheelchair. Amputation of her lower limb under the knee was also considered. SPN entrapment was diagnosed at a physical examination at EuroPainClinics. Decompression of the SPN under local anaesthesia was performed at the clinic.
Results. The symptoms improved immediately after the procedure, and following 2 months of rehabilitation, the patient was completely symptom-free. Her clinical state remains unchanged until this day.
Conclusions. SPN entrapment is not a common diagnosis in the group of pain syndromes. Regarding the lower limb, it is imperative to include it on the list of differential diagnoses in cases of pain and functional disorders of the lateral muscle groups of the calf and leg. In the case of SPN entrapment, EMG findings may be negative.
About the Authors
R. Rapčan
EuroPainClinics
Slovakia
Slovakia
Róbert Rapčan
94/3Na hradbách, 08501 Bardejov
L. Kočan
Clinic of Anaesthesiology and Intensive Care Medicine, East Slovak Institute of Cardiovascular Disease
Slovakia
Slovakia
Ladislav Kočan
8 Ondavská, 04011 Košice
H. Alfredson
Alfredson Tendon Clinic
Sweden
Sweden
Håkan Alfredson
Malmö
R. Sudzina
Neurological clinic, East Slovak Institute of Cardiovascular Disease
Slovakia
Slovakia
Rudolf Sudzina
8 Ondavská, 04011 Košice
S. Rapčanová
EuroPainClinics
Slovakia
Slovakia
Simona Rapčanová
94/3Na hradbách, 08501 Bardejov
M. Buriánek
EuroPainClinics
Czech Republic
Czech Republic
Miroslav Buriánek
1750/91 Starochodovská, 14900 Prague 4
P. Török
Clinic of Anaesthesiology and Intensive Care Medicine, East Slovak Institute of Cardiovascular Disease
Slovakia
Slovakia
Pavol Török
8 Ondavská, 04011 Košice
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Review
For citations:
Rapčan R., Kočan L., Alfredson H., Sudzina R., Rapčanová S., Buriánek M., Török P. Elusive Diagnosis of Superficial Peroneal Nerve Entrapment Case report. General Reanimatology. 2021;17(4):29-36. https://doi.org/10.15360/1813-9779-2021-2-00-00
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