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Slimmer's paralysis in a physical trainer with drastic weight fluctuations
Vivek Shankar1, Nitish Jagdish Jyoti2, Swayam Prakash Dash1
1Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
BMJ Case Reports
|January 14, 2025
Summary
Slimmer's paralysis, or common peroneal (fibular) neuropathy, can result from rapid weight loss causing nerve compression. This case highlights the diagnostic challenges and the need for tendon transfer over surgical decompression.
Area of Science:
- Neurology
- Orthopedics
Background:
- Slimmer's paralysis is a peripheral mononeuropathy affecting the common peroneal (fibular) nerve.
- It typically occurs due to rapid weight loss, leading to reduced subcutaneous fat and nerve compression at the fibular head.
Purpose of the Study:
- To describe a case of common peroneal (fibular) neuropathy following rapid intentional weight loss.
- To discuss the diagnostic challenges and management of this condition.
Main Methods:
- Case report of a young man with a 1-year history of foot drop.
- Electrophysiological studies to assess nerve function.
- Radiological assessment of the lumbosacral spine.
Main Results:
- The patient experienced right-sided foot drop after losing 11 kg in 15 days, preceded by binge eating.
- Electrophysiological studies confirmed common peroneal (fibular) neuropathy at the fibular head with persistent denervation.
- Lumbosacral spine imaging was unremarkable.
Conclusions:
- This case underscores the diagnostic difficulty in differentiating common peroneal (fibular) neuropathy from lumbosacral plexopathy or radiculopathy.
- Neither surgical decompression of the common peroneal nerve nor lumbosacral decompression is indicated.
- Tendon transfer is emphasized as a beneficial treatment option.
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