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At least 19 recordsLinked to original sources
PubMed1987

Modification of median nerve somatic evoked potentials by prior median nerve, peroneal nerve, and auditory stimulation.

In a recovery function design, changes were measured in the somatic evoked potential (SEP) to right median nerve (RMN) shocks preceded by stimulation of: the same nerve (RMN-RMN); the left median nerve having primary input to the homologous sensory area in the contralateral hemisphere (LMN-RMN); the right peroneal nerve having primary input to a different region of the same hemisphere (RPN-RMN); and the auditory nerve with primary input to a different sensory modality (AUD-RMN). Eight inter-stimulus intervals ranged from zero (simultaneous) to 2.5 sec. It was assumed that the degree of interaction between evoked potentials would be related to the degree to which common neural structures are activated or modulated in response to the stimuli. Results were: (a) the primary somatosensory response N20-P30 was little influenced by other somatic or auditory stimulation, interaction occurring predominantly in the RMN-RMN condition; (b) with increasing latency, components showed increasing interaction across modalities; (c) preceding homolateral stimulation (RPN-RMN) showed no greater interaction than preceding contralateral stimulation (LMN-RMN); (d) N55-P100 differed from the primary somatosensory response N20-P30 by showing greater interaction with other somatic stimuli; and (e) N140-P190 showed similarly shaped recovery functions across stimulus pairs but significant differences in magnitude of interaction. These results show that components with similar wave form and topographical characteristics can have different neurophysiological properties.

Acoustic Stimulation↗
PubMed1992

Anatomic considerations of pin placement in the proximal tibia and its relationship to the peroneal nerve.

Peroneal nerve impalement is a recognized complication of percutaneous placement of wires, which is gaining increased usage with the application of the techniques of Ilizarov, Monticelli, and Spinelli. Dissections of the peroneal nerve in the proximal tibia were performed in ten anatomic specimens (20 legs) to define (1) its relationship to palpable landmarks, (2) distribution of major branches to the musculature, and (3) safe zones of placement of percutaneous wires in the proximal tibia. The anterior recurrent tibial nerve was frequently in an area of risk where it courses proximally in the anterior compartment. A safe zone is located anterior to the palpable portion of the fibular head and up to 2 cm distal to the tip of the fibular head.

Humans↗
PubMed2005

Missile-caused complete lesions of the peroneal nerve and peroneal division of the sciatic nerve: results of 157 repairs.

OBJECTIVE: There are few large-volume studies of the repair of complete missile-caused peroneal nerve and peroneal division lesions. In this prospective study, the outcomes of such repairs are studied and the factors influencing the outcomes are analyzed. METHODS: During a 3-year period, 157 patients with complete missile-caused lesions of the peroneal nerve or peroneal division were treated surgically in the Belgrade Military Medical Academy: 37 patients with high-level (above the middle of the thigh), 90 patients with intermediate-level (above the popliteal crease), and 30 patients with low-level repairs. After at least 4 years of follow-up, outcome was defined on the basis of motor recovery, neurophysiological recovery, and patient judgment of the quality of outcome (poor, insufficient, good, or excellent). Good and excellent outcomes were considered successful. The factors of repair level, defect length, manner of repair, preoperative interval, severity of tissue damage in the repair region, and patient age were studied for their effect on outcome. RESULTS: A successful outcome was obtained in 10.8% of high-level repairs, 31.1% of intermediate-level repairs, and 56.7% of low-level repairs (P < 0.001). Nerve defect and preoperative interval were significantly shorter for patients with a successful outcome compared with those with an unsuccessful outcome (P< 0.001). Worsening of the outcome began with the nerve defect larger than 4 cm and preoperative interval greater than 3 months (P< 0.001). Severity of local tissue damage significantly influenced the outcome (P= 0.008). Repair level (P< 0.001), preoperative interval (P= 0.001), severity of local tissue damage (P= 0.011), and length of nerve defect (P= 0.011) were independent predictors for a successful outcome. CONCLUSION: After peroneal nerve or peroneal division repairs, a successful outcome is most probable with low-level lesions repaired in the first 3 months after injury using grafts smaller than 4 cm. Conversely, high-level repairs delayed for more than 7 months after injury and using grafts larger than 8 cm are probably not worthwhile.

Adolescent↗
PubMed2001

[Innervation pattern to the extensor digitorum brevis by deep peroneal nerve and accessory deep peroneal nerve].

On the electrophysiological basis, extensor digitorum brevis(EDB) muscle is innervated electrophysiologically not only by deep peroneal nerve(DPN) but also by accessory deep peroneal nerve(ADPN), an anomalous branch of superficial peroneal nerve, with a prevalence of 17-28%. We investigated 23 patients who had both DPN and sufficient ADPN innervation to the EDB on the intramuscular distribution of DPN and ADPN innervation to the medial and lateral side of the EDB. Recording electrodes were placed on the medial and lateral edges of the EDB with a supramaximal stimulation to the anterior or lateral ankle, compound muscle action potential (CMAP) of DPN or ADPN innervation was recorded. In 19 patients (83%) the DPN innervation was larger than or equal to the ADPN innervation. Only in 4 patients (17%) the ADPN innervation obviously exceeded the DPN innervation. DPN enters to the EDB from the medial side, and ADPN from the lateral side of the EDB. In 16 patients(70%) the DPN innervation was relatively large and the ADPN innervation was relatively small at the medial side of the EDB, and vice versa at the lateral side of the EDB. These distributions were almost uniform in 5 patients(22%). This study clarified that a biased larger DPN innervation and smaller ADPN innervation to the medial side of the EDB, and vice versa to the lateral side of the EDB in the majority cases. In some cases diffuse innervation to the EDB was found.

Action Potentials↗
PubMed1999

The possibility of deep peroneal nerve neurotisation by the superficial peroneal nerve: an anatomical approach.

Neurotisation involves transfer of nerves for the restoration of function following injury. A number of nerves have been used in different part of the peripheral nervous system. This study was undertaken to develop a practical and relatively safe surgical approach to the treatment of L4 root lesion's. We examined the effectiveness and safety of neurotisation of the deep peroneal nerve and its branches by the superficial peroneal nerve. Twelve legs of dissected cadavers provided for teaching purposes in the anatomy laboratory were used to display the common peroneal nerve and its branches. Each branch was measured using calipers and analysed to investigate the possibility of neurotisation of the deep peroneal nerve by the superficial peroneal nerve and its branches. It was found that of the measured branches, transposition was possible between those to peroneus longus and tibialis anterior on the basis of their diameter and length. In recent decades, advances in microsurgical reconstruction and understanding of the microanatomy have played major roles in improving the results of surgical treatment of nerve injuries. There is a need for further experimental studies on the feasibility of this surgical approach.

Dissection↗
PubMedDate not supplied

Compartment block for foot surgery. A new approach to tibial nerve and common peroneal nerve block.

BACKGROUND AND OBJECTIVES: The concept of single injections of local anesthetics into fascial compartments was pioneered by Winnie in reports on paravascular techniques. Winnie described an axillary approach for brachial plexus block and the inguinal route for lumbar plexus block. The compartmental principle can, with advantage, be extended to more peripheral anesthesia of the tibial and common peroneal nerves by the use of osteofascial compartments in the leg. METHODS: A brief description of the relevant anatomy is followed by the method and results of a study designed to test the ease of performance and efficacy of these techniques for 20 healthy patients scheduled for foot surgery. RESULTS: The new blocks were easy to perform and the patients experienced prolonged postoperative analgesia probably due to confinement of the local anesthetic in enclosed compartments. CONCLUSIONS: Further studies of compartmental anesthesia for other nerve trunks and plexuses may be of value.

Electric Stimulation↗
PubMed2001

Compound nerve action potential of common peroneal nerve recorded at fibular neck: its clinical usefulness.

OBJECTIVE: To determine the clinical usefulness of the compound nerve action potential of the common peroneal nerve recorded immediately distal to or at the fibular neck, at the same time stimulating the common peroneal nerve laterally at the posterior knee. DESIGN: For recording the compound nerve action potential of the common peroneal nerve, the active recording electrode was secured just distal to or at the fibular neck area, whereas the stimulating electrode was placed on the medial border of the lateral hamstring tendon at the level of the popliteal crease. To reduce shock artifacts, a biphasic stimulation was used. RESULTS: In 35 adults (n = 19 men), 70 nerves were tested. The compound nerve action potential from each individual was recorded. The compound nerve action potential amplitude of a baseline-to-negative peak and conduction velocity were measured on both sides. For comparisons of the side-to-side amplitude and conduction velocity, Wilcoxon's signed-rank test was applied. CONCLUSION: This approach of recording the compound nerve action potential of the common peroneal nerve, in addition to conventional methods, may enhance the process of determining the precise localization of peroneal nerve lesion in the knee.

Action Potentials↗
PubMed2001

Distal sensory nerve conduction of the superficial peroneal nerve: new method and its clinical application.

The superficial peroneal nerve subserves sensation on the entire surface of the dorsum of the foot, except in small areas. All previously reported techniques for evaluating nerve conduction along this nerve tested a proximal portion of the nerve. We report a new method for evaluating sensory nerve conduction of the four branches of the distal superficial peroneal nerve. Two branches to the second and third toes of the medial dorsal cutaneous nerve and two branches to the fourth and fifth toes of the intermediate dorsal cutaneous nerve were studied orthodromically and antidromically in 37 feet of 21 normal volunteers using surface stimulating and recording electrodes and with a distance of 10 cm between the stimulating and recording electrodes. Maximum nerve conduction velocities (NCV) ranged from 41.8 to 46.9 m/s, and mean response amplitude ranged from 6.5 to 7.6 microV with the orthodromic technique. Values for NCV were almost identical when elicited by antidromic and orthodromic techniques, but response amplitudes were higher with the antidromic technique. Mean amplitudes of the distal superficial peroneal nerve were about 50% of the proximal superficial peroneal, and the conduction velocity in the distal superficial peroneal was slower than that in the proximal superficial peroneal nerve, by 8-14 m/s. In seven cases, distal superficial peroneal neuropathy was confirmed with this technique: two with proper digital neuropathy, two with medial dorsal cutaneous neuropathy, and three with intermediate dorsal cutaneous neuropathy.

Adult↗
PubMed1986

An algorithm for the management of ligamentous injuries of the knee associated with common peroneal nerve palsy.

Peroneal nerve palsy is the result of traction of the nerve at the fibular head and can be seen after varus injuries of the knee. The complication is uncommon and spontaneous, useful recovery is unusual. The treatment of either the ligamentous injury or the nerve injury alone is uncomplicated. However, when these injuries are seen in combination, management is more complicated. The clinical and laboratory findings of the nerve palsy in such a situation are reviewed. In addition, an algorithm has been constructed that is useful in determining the appropriate diagnostic and therapeutic steps in managing combined injuries.

Humans↗
PubMed2000

Surgical treatment for peroneal nerve palsy.

BACKGROUND: Peroneal nerve palsy is the most frequently encountered mononeuropathy of the lower extremities. Although many studies advocated spontaneous resolution of peroneal nerve palsy, more recent studies confirmed obvious improvement with surgical treatment techniques. METHODS: This study reviewed the results obtained from surgically treated peroneal nerve palsy in 14 patients who were admitted to our hospital between 1990 and 1996. The patients consisted of 12 males and two females with an average age of 31 years (range, 12-68 years). Peroneal nerve palsy in these patients was caused by direct or indirect injury, as confirmed by clinical examination and electromyography. The status of the nerve was observed for at least 4 months and explored when the nerve failed to reveal evidence of recovery. The nerve was decompressed, repaired or reconstructed by nerve grafting, according to the status of the injury. Weber scales were used to assess the peripheral neuropathies preoperatively and postoperatively. RESULTS: At a mean of 23 months (range, 11-61 months), nerve palsy scores improved from an average of 5 points to 3.14 points. Despite the small number of patients, our results indicated that the time interval between onset of injury and date of surgical treatment (p < 0.05) was the most significant factor to influence the prognosis of surgery. Results obtained from surgery were not related to the method of treatment, length of nerve graft or mechanism of injury. CONCLUSIONS: Because peroneal nerve palsy does not always resolve spontaneously, this study favored early surgical exploration for peroneal nerve dysfunction, based on at least 4 months of follow-up.

Adolescent↗
PubMed1987

Analysis of somatosensory evoked potentials in peroneal nerve palsy.

The peroneal nerve SEPs over the CZ' of the scalp were studied in patients with peroneal nerve palsy. The initial positive peak latencies of P27 (to popliteal fossa stimulation), P30 (to fibular neck stimulation) and P37 (to dorsum of the foot stimulation) were measured. The latency difference P30-P27 was prolonged in all patients with the fibular head lesions. In patients with the superficial peroneal nerve lesions at the foreleg, P37-P27 was prolonged whereas P30-P27 was normal. Clinical application of peroneal nerve SEPs was useful in deciding the site of the lesion causing the peroneal nerve palsy.

Adult↗
PubMed1996

[Association between abnormal sensation and increased microneurographic muscle sympathetic nerve activity of the peroneal nerve in patients with lumbar spinal problems].

Nine patients with lumbar spinal problems (patient group) and four healthy volunteers as a control group were examined by the microneurographic technique. A tungsten microelectrode (impedance 2 approximately 5 M omega) was introduced into the peroneal nerve in the affected limb in the patient group. Muscle sympathetic nerve activities were rectified and integrated every 0.1 sec. Muscle sympathetic nerve activity was expressed as the burst number of integrated muscle sympathetic nerve activities per minute (burst rate) and the burst number per 100 heart beats (burst incidence). Statistical analyses were performed by ANOVA. The mean burst rate was 22.5 +/- 5.3 burst/min in the patient group, and 11.9 +/- 1.9 burst/min in the control group. The mean burst incidence was 31.7 +/- 8.2 burst/100 HB in the patient group and 17.1 +/- 4.3 burst/100 HB in the control group. Both the mean burst rate and mean burst incidence were higher in the patient group than in the control group (mean burst rate: p < 0.005, mean burst incidence: p < 0.01). In 62.5% of the patients with increased muscle sympathetic nerve activity, dysesthesia (tingling, and pin prick sensations) was complained of. There was a positive correlation between dysesthesia and increased basic activity of the muscle sympathetic nerve. This suggests the sympathetic nervous system may be involved in inducing abnormal sensations.

Adult↗
PubMed2005

Complete innervation of extensor digitorum brevis by accessory peroneal nerve.

The accessory peroneal nerve is a normal anatomical variant, electrophysiologically present in 15-28% of normal individuals. An individual with a rare, complete innervation of extensor digitorum brevis muscle by an accessory peroneal nerve is reported, emphasizing the importance of proximal stimulation during routine electrodiagnostic evaluation despite absent distal responses to avoid misdiagnosing axonal lesions.

Electric Stimulation↗
PubMed1994

"Congenital" common peroneal nerve compression.

Common peroneal nerve palsies may arise from numerous causes. We report an unusual case of common peroneal nerve palsy secondary to a previously unreported congenital band crossing the nerve at the level of the fibular head.

Adolescent↗
PubMed2006

[Peroneal nerve schwannoma presenting with a peroneal palsy].

Peroneal nerve injury in the lateral aspect of the knee is frequent, commonly dominated by traumatic or compressive etiologies. Tumors, generally synovial cysts, are exceptional causes. We report a case of a 70-year-old women referred for assessment of peroneal palsy syndrome found to be related to peroneal schwannoma in the lateral aspect of the knee. Schwannoma is the most frequent peripheral nerve benign tumor. It is commonly limited to cranial and upper limb nerves. Localization on the lower limbs (sciatic nerve) has been reported in 1 percent of cases. The peroneal nerve localizaton has not been reported to date. We underline difficulties of diagnosis inherent to this particular localization.

Aged↗
PubMed2006

The influence of continuous exposure to 50 Hz electric field on nerve regeneration in a rat peroneal nerve crush injury model.

The effect of power frequency electric field (EF) on nerve regeneration was investigated on a rat peroneal nerve crush injury model. The animals were assigned to three groups: 50 Hz EF and Static EF groups were exposed at 10 kV/m. The sham group was kept in the same setting without any EF applications. EF was uninterruptedly applied for 21 days postoperatively. Repeated measures analysis of daily walking tracks during EF exposure demonstrated lower toe spread recovery (TSR) in the 50 Hz EF group. Significant difference across the groups was found only at days 7, 8, 12, 16, 17, 20, and 21 when TSR was analyzed for each measurement time. Print length recovery and peroneal function index did not differ across the groups. Walking track parameters were found to recover to their baseline values by day 28 in all groups. Day 14 but not day 21 measurements revealed smaller nerve cross-sectional area, lower total regenerating axon area, and higher mean myelin debris area in 50 Hz EF group. Both day 14 and 21 measurements revealed higher total myelin debris area, lower EDL muscle weight, and lack of significant enlargement in nerve cross-section distal to the injury, compared to the normal counterpart in 50 Hz EF group. All differences were in keeping with lower rates of Wallerian degeneration and nerve regeneration in 50 Hz EF group. When walking track, histomorphometry and muscle weight are considered individually, their differences across the groups may appear to be subtle to derive a conclusion for a 50 Hz EF effect. However, their concordance with each other in direction of effect suggests that continuous 50 Hz EF exposure has a weak effect that is detrimental mostly to the rate of early nerve regeneration in this axonotmetic injury model. Recovery of walking tracks was not different between Static EF and Sham groups. This suggests that the surface charges that may indirectly affect walking behaviors of the rats, do not account for the lower recovery of TSR in 50 Hz EF group. Differences in nerve regeneration between 50 Hz EF and Static EF groups suggests that electric induction may be required for pure EF effects even though the estimated density of induced fields is not above the endogenous background level for the 50 Hz EF exposure in this study.

Animals↗