Idiopathic Pediatric Tibial Nerve Palsy

Area of Science:

• Pediatric Neurology
• Surgical Case Study
• Neurophysiology

Background:

• Tibial nerve entrapment is infrequently diagnosed in pediatric patients.
• It poses significant diagnostic and therapeutic hurdles.
• The etiology of lower leg atrophy in children can be challenging to determine.

Observation:

• A 3-year-old male presented with progressive lower leg atrophy of unclear origin.
• Preoperative electrodiagnostic studies and MRI indicated proximal tibial neuropathy.
• Surgical findings revealed tibial nerve compression at the long head of the biceps femoris and soleal sling.

Findings:

• Surgical exploration identified tibial nerve compression at two specific anatomical locations.
• The primary intervention involved release and external neurolysis of the affected nerve.
• Post-operative assessment demonstrated notable improvement in distal leg motor function.

Implications:

• This case highlights the possibility of tibial nerve entrapment in pediatric lower leg atrophy.
• It underscores the utility of electrodiagnostic testing and MRI in diagnosis.
• Successful surgical decompression offers a viable treatment option for pediatric tibial neuropathy.