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Common peroneal nerve dysfunction
Alternative namesNeuropathy - common peroneal nerve; Peroneal nerve injury; Peroneal nerve palsy
DefinitionCommon peroneal nerve dysfunction is a disorder caused by damage to the peroneal nerve, characterized by loss of movement or sensation in the foot and leg.
Causes, incidence, and risk factors
The peroneal nerve is a branching of the sciatic nerve, which supplies movement and sensation to the lower leg, foot and toes. Common peroneal nerve dysfunction is a type of peripheral neuropathy (damage to nerves outside the brain or spinal cord). This condition can affect people of any age.
Damage to the nerve destroys the covering of the nerve cells (the myelin sheath) or causes degeneration of the entire nerve cell. There is a loss of muscle control, loss of muscle tone, and eventual loss of muscle mass because of lack of nervous stimulation to the muscles.
Another risk is being extremely thin or emaciated (for example, from anorexia nervosa ). Systemic conditions such as diabetic neuropathy or polyarteritis nodosa can also cause damage to the common peroneal nerve. Charcot-Marie-Tooth disease (hereditary sensorimotor neuropathy) is an inherited disorder that affects all nerves, with peroneal nerve dysfunction apparent early in the disorder. Also, toxic chemical exposure, like to polyvinyl choloride or to styrene during the production of polysterene, may lead to peroneal and other nerve damage.
Signs and testsExamination of the legs may show a loss of muscle control over the legs and feet. The foot or leg muscles may atrophy (lose mass). There is difficulty with dorsiflexion (lifting up the foot and toes) and with eversion (toe-out movements).
Muscle biopsy or a nerve biopsy may confirm the disorder, but they are rarely necessary.
Tests of nerve activity include:
Treatment is aimed at maximizing mobility and independence. The cause should be corrected, if possible, to reduce further damage.
Corticosteroids injected into the area may reduce swelling and pressure on the nerve in some cases.
Surgery may be required if the disorder is persistent or symptoms are worsening, if there is difficulty with movement, or if there is evidence on testing that the nerve axon is degenerating. Surgical decompression of the area may reduce symptoms if the disorder is caused by entrapment of the nerve. Surgical removal of tumors or other conditions that press on the nerve may be of benefit.
Over-the-counter or prescription analgesics may be needed to control pain ( neuralgia ). Other medications may be used to reduce the stabbing pains that some people experience, including gabapentin, carbamazepine, or tricyclic antidepressants such as amitriptyline. Whenever possible, medication use should be avoided or minimized to reduce the risk of side effects.
If pain is severe, a pain specialist should be consulted so that all options for pain treatment are explored.
The outcome depends on the underlying cause. Successful treatment of the underlying cause may resolve the dysfunction. Resolution may take several months until the nerve can grow back.
Alternately, if nerve damage is severe, disability may be permanent. The nerve pain may be quite uncomfortable. This disorder does not usually shorten the expected life span.
Calling your health care providerCall your health care provider if you have symptoms that indicate common peroneal nerve dysfunction.
Avoid prolonged pressure to the back of the knee. Injuries to the leg or knee should be treated promptly.
If a cast, splint, dressing, or other possible constriction of the lower leg causes a tight feeling or numbness, notify your health care provider.
Update Date: 1/16/2004Jacqueline A. Hart, M.D., Newton-Wellesley Hosptial, Newton, Ma., and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network (7/28/2002).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT