Common Fibular Nerve Palsy in a Cyclist after Bariatric Surgery - Case Report

Area of Science:

• Neurology
• Orthopedics
• Bariatric Surgery Outcomes

Background:

• Common fibular nerve (CFN) palsy is a frequent lower limb mononeuropathy with diverse causes.
• Risk factors include leg crossing, trauma, and significant weight loss, often leading to fibular neck compression.
• Surgical decompression is considered for persistent neurological deficits.

Purpose of the Study:

• To report a case of common fibular nerve palsy following bariatric surgery and substantial weight loss.
• To highlight strenuous physical activity as a potential trigger in this specific patient population.

Main Methods:

• Case report of a 39-year-old male amateur cyclist post-bariatric surgery.
• Clinical presentation of paresthesia and dorsiflexion impairment after strenuous cycling.
• Electromyographic confirmation of CFN palsy and subsequent surgical nerve decompression.

Main Results:

• The patient developed common fibular nerve palsy eleven months after losing over 30% of his body mass.
• Surgical decompression resulted in positive outcomes over a ten-month follow-up period.
• The case demonstrates a link between significant post-bariatric weight loss, physical exertion, and CFN palsy.

Conclusions:

• Common fibular nerve palsy should be considered in patients presenting with lower limb neurological deficits after bariatric surgery and weight loss.
• Strenuous physical activity may precipitate symptoms in susceptible individuals.
• This etiology warrants inclusion in differential diagnoses for atraumatic neuropathies in this context.