Common peroneal neuropathy in patients after first-time stroke

Area of Science:

• Neurology
• Neurophysiology
• Electromyography

Background:

• Common peroneal neuropathies at the fibular head are a known cause of drop foot.
• Drop foot is frequently assessed in electromyography (EMG) laboratories.

Purpose of the Study:

• To investigate the motor conduction properties of the common peroneal nerve and its branches in stroke patients with drop foot.
• To explore the hypothesis that foot inversion post-stroke may lead to neuropathy around the fibular neck.

Main Methods:

• Peroneal nerve conduction studies were conducted on 76 legs of 38 stroke patients (12-73 days post-stroke).
• Motor nerve conduction latency and compound muscle action potential (CMAP) amplitude were measured in the deep and superficial peroneal nerves.
• Conduction properties of the paralyzed leg were compared to the sound leg using paired t-tests.

Main Results:

• Statistically significant differences (P<0.05) were observed in motor conduction latencies and CMAP amplitudes between the paralyzed and sound legs.
• These significant differences were noted in both the deep and superficial peroneal nerves.

Conclusions:

• The persistent equino-varus foot position in paralyzed limbs may impair common peroneal nerve conduction at the fibular neck through demyelination or axonopathy.
• Potential causes include nerve traction, compression, or temperature changes; ankle-foot orthoses are recommended for prevention and correction.