Peroneal nerve schwannoma presenting with a peroneal palsy

Peroneal nerve injury in the lateral aspect of the knee is frequent, commonly dominated by traumatic or compressive etiologies. Tumors, generally synovial cysts, are exceptional causes. We report a case of a 70-year-old women referred for assessment of peroneal palsy syndrome found to be related to peroneal schwannoma in the lateral aspect of the knee. Schwannoma is the most frequent peripheral nerve benign tumor. It is commonly limited to cranial and upper limb nerves. Localization on the lower limbs (sciatic nerve) has been reported in 1 percent of cases. The peroneal nerve localizaton has not been reported to date. We underline difficulties of diagnosis inherent to this particular localization.     

Involvement of superficial peroneal sensory nerve in common peroneal neuropathy

Motor involvement in common peroneal neuropathy (CPN) frequently shows a selective pattern with regard to deep and superficial divisions of the peroneal nerve, by clinical examination and needle electromyography. The involvement of the sensory branch of the superficial peroneal nerve (SPN) has not been well established using nerve conduction studies. Among 42 cases of electrophysiologically defined CPN in 35 patients, 37 (88%) had clinical or electrophysiologic evidence for SPN involvement, but only 20 had diminished superficial peroneal sensory response (SPSR) amplitudes. Many of the cases involving normal SPSRs had significant axonal loss involving deep peroneal motor fibers. Sparing of the superficial peroneal sensory fibers provides further evidence for the selective vulnerability of different nerve fascicles to injury. This is an important pattern to recognize; from a practical standpoint, focal segmental conduction abnormalities in the motor nerve and EMG findings can help to differentiate these lesions from L-5 radiculopathy.     

Anomalous origin of the sural nerve in a patient with tibial—common peroneal nerve anastamosis

Recognition of anomalous innervation patterns may be important in dealing with peripheral nerve injuries. We describe a patient who suffered injury to the common peroneal nerve (CPN) at the knee when he laterally dislocated his knee. Intraoperative nerve conduction studies during surgical exploration revealed that nerve fibers from the tibial nerve crossed over to join the CPN immediately distal to a neuroma incontinuity. The sural nerve was also found to arise totally from the CPN. © 1993 John Wiley & Sons, Inc.     

腓骨肌萎缩症的病理和超微结构改变

目的　总结腓骨肌萎缩症 (HMSNⅠ型和Ⅱ型 )周围神经的病理改变及其特征。　　方法　采用单纤维分离、光镜及电镜观察 5例HMSNⅠ型、2例HMSNⅡ型腓肠神经的病理改变。　　结果　光镜下HMSNⅠ型患者大直径有髓纤维几乎完全消失 ,HMSNⅡ型部分保留 ,Ⅰ型各例均可见大量洋葱头样结构 ,Ⅱ型则无。电镜观察同样见到Ⅰ型患者有大量洋葱头样结构 ,并有较多膜性结构和雪旺氏细胞胞浆突起成分。Ⅱ型可见髓鞘坏变、塌陷 ,轴索内空泡变性。　　结论　HMSNⅠ型的基本病理改变为雪旺氏细胞病变 ,Ⅱ型则为轴索变性。     

Intraneural cyst of the peroneal nerve

A 15-year-old girl was referred to us because of foot drop. The motor deficit was characterized by a peculiar fluctuating course related to sporting activity: improvement of symptoms during no-sport periods and worsening during sport training. Neurophysiological examination revealed marked global impairment of muscles innervated by the peroneal nerve. Ultrasound and MRI showed a mass in close proximity to the neck of the fibula extending in a tubular fashion. At operation an intraneural lesion was found and was totally removed. Histology revealed that it was an intraneural cyst. A hypothesis on the pathogenesis was drawn up. One year after the operation a clinical and neurophysiological follow-up was performed. Received: 2 April 1997 Revised: 27 May 1997     

Atypical deep peroneal neuropathy in the setting of an accessory deep peroneal nerve

We report a case of deep peroneal neuropathy resulting in foot drop with preserved toe extension. These unexpected findings were the result of the presence of an accessory deep peroneal nerve that provided total innervation of the extensor digitorum brevis. We review the literature on total innervation of the extensor digitorum brevis by the accessory deep peroneal nerve with and without an associated deep peroneal nerve lesion. Muscle Nerve 40: 313–315, 2009     

Atypical deep peroneal neuropathy in presence of accessory deep peroneal nerve

The clinical and electrophysiological findings in two patients with a deep peroneal neuropathy occurring in the presence of significant innervation of the extensor digitorum brevis muscle by the accessory deep peroneal nerve are reported. This nerve is a branch of the superficial peroneal nerve which was not involved in either cases reported. An awareness of this anatomical variation of innervation of the extensor digitorum brevis muscle is important for the correct clinical and electromyographic evaluations of deep peroneal nerve lesions. The electromyographic findings in this situation are sufficiently characteristic to identify clearly this anatomical variant. From a clinical point of view, residual function in the lateral portion of the extensor digitorum brevis muscle, in the face of an otherwise complete deep peroneal palsy, should suggest this anatomical variation.     

Ultrasound imaging of the rabbit peroneal nerve

Ultrasound imaging of peripheral nerves is increasingly used in the clinic for a wide range of applications. Although yet unapplied for experimental neuroscience, it also has potential value in this research area. This study explores the feasibility, possibilities and limitations of this technique in rabbits, with special focus on peripheral nerve regeneration after trauma. The peroneal nerve of 25 New Zealand White rabbits was imaged at varying time intervals after a crush lesion. The ultrasonic appearance of the nerve was determined, and recordings were validated with in vivo anatomy. Nerve swelling at the lesion site was estimated from ultrasound images and compared with anatomical parameters. The peroneal nerve could reliably be identified in all animals, and its course and anatomical variations agreed perfectly with anatomy. Nerve diameters from ultrasound were related to in vivo diameters (p < 0.001, R(2) = 77%), although the prediction interval was rather wide. Nerve thickenings could be visualized and preliminary results indicate that ultrasound can differentiate between neuroma formation and external nerve thickening. The value of the technique for experimental neuroscience is discussed. We conclude that ultrasound imaging of the rabbit peroneal nerve is feasible and that it is a promising tool for different research areas within the field of experimental neuroscience.     

Polyglucosan bodies in the sural nerve of a diabetic patient with polyneruopathy

Summary In the sural nerve of a 62-year-old woman with impaired glucose tolerance test and polyneuropathy, many intra-axonal polyglucosan bodies were observed. Polyglucosan bodies have been described in spontaneously or alloxan-diabetic rats, but are not usually observed in human diabetic neuropathy. Since intra-axonal polyglucosan bodies can occur in the sural nerve in various diseases and in aging, they are considered as non-specific changes. Their presence is probably related to a primary axonal neuropathy.Supported in part by CNR (Center for Cerebral Neurophysiclogy, Genova) and by CNR contract no. 83.02062.04     

Gelatinous cyst of the common peroneal nerve.]

The authors report two cases of gelatinous cyst of the common peroneal nerve. They present two different approaches to surgical treatment used in their cases--decompression of the nerve trunk by simple drainage of the cyst in one case and total excision of the cyst and its wall with reconstruction of fascicles damaged by the lesion in another. Experiences and results of treatment by other authors are presented as well as their views on pathology and etiology of this rare entity.     

Ganglionic cyst of the deep peroneal nerve: description of a case

The case of a patient with a small intraneural ganglion of the deep peroneal nerve is described, including the clinical and electrophysiological characteristics and the course four years after surgery.     

Intraneural cyst: a rare cause of peroneal nerve palsy

A 30 year-old man presented with progressive left peroneal nerve palsy. At surgery, an intraneural cystic tumour was found in the common peroneal nerve. Pathological examination showed that the tumour was of synovial origin.     

Reversible conduction block of peroneal nerve associated with SARS-CoV-2

Neurological Sciences - The ongoing SARS-CoV-2 pandemic, which is dramatically spreading worldwide, is well known for its respiratory&nbsp;sequelae. Besides cases of Guillain-Barré...     

Mononeuropathy of the medial branch of the deep peroneal nerve in a scuba diver.

Peripheral mononeuropathies occur only rarely in association with decompression illness. The sites previously reported to be affected are areas of potential entrapment in which a peripheral nerve traverses a confined area. In these instances, the pathophysiology has been presumed to be mechanical pressure in an enclosed space by a gas bubble. A rare case is now presented of a peripheral mononeuropathy of the medial branch of the deep peroneal nerve in a scuba diver following surfacing from a 195 foot dive. This case differs from prior reports of mononeuropathy in association with decompression illness in that the affected nerve does not traverse a confined site in which mechanical compression by a gas bubble is likely. The mechanism of injury is hypothesized to be a manifestation of decompression illness with a gas bubble causing blood flow obstruction and an ischemic infarct.     

An electrophysiological study of the deep peroneal sensory nerve

The electrodiagnosis of peripheral neuropathy is often based on nerve conduction abnormalities in sensory nerves of the lower extremities. We performed nerve conduction studies of the deep peroneal sensory nerve prospectively in 63 limbs of 38 normal subjects. The sensory amplitudes showed a decreasing trend with increasing age. 21% of subjects had absent sensory potentials, especially those in the older age groups. This was seen in contrast with superficial peroneal and sural potentials, which were universally present. Although the deep peroneal sensory nerve is located in the distal lower limb, it should be used with caution in evaluating peripheral neuropathy, in view of the frequent occurrence of absent potentials even in asymptomatic normal subjects.