Sural mononeuropathy: a report of 36 cases

Isolated sural mononeuropathy is rare and frequently constitutes a diagnostic challenge.

This investigation was a retrospective study of sural neuropathy at a single electrodiagnostic center.

Our study included 36 patients with sural neuropathy, the largest sample so far reported. Non-surgical, non-traumatic etiologies account for 50% of the cases, including 7 patients with inflammatory or vasculitic conditions. Routine sural conduction study was positive in 34 of 36 patients, whereas a distal recording method was used to verify the diagnosis of sural mononeuropathy in 2 patients. Most (58%) patients did not require specific treatment, but persistent sensory symptoms were seen in a minority of cases. Sural nerve biopsy in 1 patient helped diagnostic and treatment planning.

Sural mononeuropathy has distinct etiologic, clinical, and electrophysiological features. Recognition can be beneficial in treating patients with sensory symptoms involving the distal lower extremity.