Pain syndrome following compression-induced common peroneal nerve neuropathy

Bashlachev M.G.; Evzikov G.Yu.; Parfenov V.A.

doi:https://doi.org/10.17116/pain20211903126

Bashlachev M.G.

Sechenov First Moscow State Medical University

Evzikov G.Yu.

Sechenov First Moscow State Medical University

Parfenov V.A.

Sechenov First Moscow State Medical University

SPIN RSCI: 3322-5559
Scopus AuthorID: 57216913889
ResearcherID: AAG-7021-2019
ORCID: 0000-0002-1992-7960

Pain syndrome following compression-induced common peroneal nerve neuropathy

Authors:

Bashlachev M.G., Evzikov G.Yu., Parfenov V.A.

More about the authors

Journal: Russian Journal of Pain. 2021;19(3): 26‑30

DOI: 10.17116/pain20211903126

Read: 18794 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Bashlachev MG, Evzikov GYu, Parfenov VA. Pain syndrome following compression-induced common peroneal nerve neuropathy. Russian Journal of Pain. 2021;19(3):26‑30. (In Russ.)
https://doi.org/10.17116/pain20211903126

Подписка 2025 Российский журнал боли (Russian Journal of Pain)

Использование инфографики авторами научных работ

Close metadata

BACKGROUND

Common peroneal nerve neuropathy is the most common type of neuropathies of the lower extremity. Lower leg and foot pain is traditionally defined as vertebrogenic pathology that results an erroneous diagnosis and incorrect treatment.

OBJECTIVE

To analyze symptoms and treatment outcomes in patients with common peroneal nerve neuropathy and pain syndrome as a leading complaint.

MATERIAL AND METHODS

There were 117 patients with compression-induced neuropathy of the common peroneal nerve at the level of fibular head for the period 2012—2021. Pain in the area of common peroneal nerve innervation was predominant complaint in 18 (15%) patients. All patients underwent surgical decompression at the level of fibular head.

RESULTS

We identified 2 patterns of pain syndrome associated with compression neuropathy of the common peroneal nerve: constant and intermittent. Persistent pain developed in 12 patients, intermittent neuropathy of the common peroneal nerve — in 6 patients. Painful neuropathy of the common peroneal nerve is often mistakenly regarded as radiculopathy of the fifth lumbar root, while intermittent form as lumbar stenosis with symptoms of neurogenic intermittent claudication. Postoperative regression of pain syndrome was noted in all patients.

CONCLUSION

Currently, clinicians do not usually associate these clinical manifestations with damage to the peroneal nerve that results diagnostic errors and incorrect treatment, as well as long-term impairment in the quality of life. Decompression of the common peroneal nerve is an effective and safe method ensuring complete regression of symptoms in patients with painful and intermittent neuropathy.

Keywords:

peroneal nerve

peroneal neuropathy

peroneal tunnel neuropathy

Authors:

Bashlachev M.G.

Sechenov First Moscow State Medical University

Evzikov G.Yu.

Sechenov First Moscow State Medical University

Parfenov V.A.

Sechenov First Moscow State Medical University

SPIN RSCI: 3322-5559
Scopus AuthorID: 57216913889
ResearcherID: AAG-7021-2019
ORCID: 0000-0002-1992-7960

Received:

18.07.2021

Accepted:

26.07.2021

Close metadata

References:

Craig A. Entrapment Neuropathies of the Lower Extremity. Electrodiagnostics Supplement. 2013(5):31-40.
Swong K, Freeman D, McCoyd M, Ibrahim W, Nielsen M, Condon B, Prabhu VC. Common Peroneal Nerve Neuroplasty at Lateral Fibular Neck: Part I — Anatomy, Clinical Presentation, and Electrophysiology. Contemporary Neurosurgery. 2017;39(12):1-6.
Myers RJ, Murdock EE, Farooqi M, Van Ness G, Crawford DC. A Unique Case of Common Peroneal Nerve Entrapment. Orthopedics. 2015;38(7):644-646.
Aprile I, Caliandro P, LaTorre G, Tonali P, Foschini M, Mondelli M, Bertolini C, Piazzini DB, Padua L. Multicenter study of peroneal mononeuropathy: clinical, neurophysiologic, and quality of life assessment. Journal of the Peripheral Nervous System. 2005;10:259-268.
Kyavar L, Heckmann JG. Bilateral Peroneal Palsy After Weightlifting. Clin J Sport Med. 2013;23(5):400-402.
Katirji MB, Wilbourn AJ. Common peroneal mononeuropathy: a clinical and electrophysiologic study of 116 lesions. Neurology. 1988;38:1723-1728.
Woltman HW. Crossing the legs as a factor in the production of peroneal palsy. The Journal of the American Medical Association. 1929;93(9):670-672.
Barinov AN, Mozolevsky YuV. Kompleksnoe lechenie tonnel’nykh nevropatij nizhnikh konechnostej. Nevrologiya, nejropsikhiatriya, psikhosomatika. 2013;5(4):10-20. (In Russ.).
Khabirov FA. Klinicheskie varianty peroneal’noj nevropatii. Prakticheskaya meditsina. 2014;2(78):10.
Van Langenhove M, Pollefliet A, Vanderstraeten G. A retrospective electrodiagnostic evaluation of footdrop in 303 patients. Electromyogr Clin Neurophysiol. 1989;29:145-152.
Jeon CH, Chung NS, Lee YS, Son KH, Kim JH. Assessment of Hip Abductor Power in Patients With Foot Drop. Spine. 2013;38(3):257-263. https://doi.org/10.1097/BRS.0b013e318268c8bc
Iwamoto N, Isu T, Chiba Y, Kim K, Morimoto D, Yamazaki K, Isobe M. Clinical feathers and treatment of peroneal nerve entrapment neuropathy. No Shinkei Geka. 2015;43(4):309-316. (In Japanese). https://doi.org/10.11477/mf.1436203012
Masakado Y, Kawakami M, Suzuki K, Abe L, Ota T, Kimura A. Clinical Neurophysiology in the Diagnosis of Peroneal Nerve Palsy. Keio J Med. 2008;57(2):84-89.
Annaswamy TM, Li HY. Atypical Presentations of Common Peroneal Neuropathy. American Academy of Physical Medicine and Rehabilitation. 2012;4:462-465. https://doi.org/10.1016/j.pmrj.2012.03.019
Conrad B, Benecke R. Electromyographic examination of gluteal muscles in the differential diagnosis of lumbar herniated discs. Arch Psychiatr Nervenkr. 1979;227:333-339.
Desai J. Common peroneal nerve palsy in maxillofacial surgery setting. Natl J Maxillofac Surg. 2017;8(1):85-86.
Kitamura T, Kim K, Morimoto D, Kokubo R, Iwamoto N, Isu T, Morita A. Dynamic factors involved in common peroneal nerve entrapment neuropathy. Acta Neurochir. 2017;159(9):1777-1781. https://doi.org/10.1007/s00701-017-3265-2
Yılmaz Ö. Bodur H. Bilateral Peroneal Nerve Palsy Due to Prolonged Squatting in a Farmer. Journal of Physical Medicine & Rehabilitation Sciences. 2015;18(1):40-43.
Sangwan SS, Marya KM, Kundu ZS, Yadav V, Devgan A, Siwach RC. Compressive peroneal neuropathy during harvesting season in Indian farmers. Tropical Doctor. 2004;34:244-246.
Iwamoto N, Kim K, Isu T, Chiba Y, Morimoto D, Isobe M. Repetitive Plantar Flexion Test as an Adjunct Tool for the Diagnosis of Common Peroneal Nerve Entrapment Neuropathy. World Neurosurgery. 2016;86:484-489. https://doi.org/10.1016/j.wneu.2015.09.080
Morimoto D, Isu T, Kim K, Sugawara A, Yamazaki K, Chiba Y, Iwamoto N, Isobe M, Morita A. Microsurgical Decompression for Peroneal Nerve Entrapment Neuropathy. Neurol Med Chir (Tokyo). 2015;55:669-673.
Zywiel MG, Mont MA, McGrath MS, Ulrich SD, Bonutti PM, Bhave A. Peroneal nerve dysfunction after total knee arthroplasty: characterization and treatment. J Arthroplasty. 2011;26(3):379-385.
Kim K, Isu T, Kokubo R, Morimoto D, Kobayashi S, Morita A. Repetitive Plantar Flexion (Provocation) Test for the Diagnosis of Intermittent Claudication due to Peroneal Nerve Entrapment Neuropathy: Case Report. NMC Case Report Journal. 2015;2:140-142.