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Complete innervation of extensor digitorum brevis by accessory peroneal nerve
1Department of Neurology, Case Western Reserve University School of Medicine and the Neurology Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA. eroboghen.eubogu@case.edu
Neuromuscular Disorders : NMD
|June 7, 2005
Summary
The accessory peroneal nerve, a common variant, can fully innervate the extensor digitorum brevis muscle. Proper electrodiagnostic testing requires proximal stimulation to avoid misdiagnosing nerve damage.
Area of Science:
- Neuroscience
- Anatomy
- Clinical Electrophysiology
Background:
- The accessory peroneal nerve (APN) is a recognized anatomical variant.
- Electrophysiological studies indicate its presence in 15-28% of the general population.
- Understanding APN variations is crucial for accurate neurodiagnostic assessments.
Observation:
- A case report details an individual with complete extensor digitorum brevis (EDB) muscle innervation solely by the APN.
- This represents a rare anatomical variation where the typical innervation pattern is altered.
- Standard electrodiagnostic evaluations may encounter challenges with this specific innervation pattern.
Findings:
- Complete APN innervation of the EDB muscle can lead to absent or diminished distal motor responses.
- Proximal stimulation techniques are essential for detecting APN activity.
- Failure to employ proximal stimulation may result in misinterpretation of nerve conduction studies.
Implications:
- Highlights the importance of proximal nerve stimulation in electrodiagnostic evaluations.
- Emphasizes the need to consider anatomical variants like the APN to prevent misdiagnosis of axonal loss.
- Contributes to the understanding of peripheral nerve variations and their clinical significance in electrophysiology.