Role of Sensory Potentials and High-resolution Ultrasonography in Confirmation of Common Peroneal Mononeuropathy at the Fibular Neck
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 70
- 主要终点
- is measuring the common peroneal nerve electrophysiological studies
研究概览
简要总结
Common peroneal mononeuropathy at the fibular neck (CPN) is one of the most frequent mononeuropathies of the lower extremities.
The common peroneal nerve sub serves sensation to the dorsum of the foot and toes. In CPN motor fibers of the deep peroneal nerve are more frequently affected than those of the superficial peroneal nerve. Fascicles of the deep branch of the common peroneal nerve are more anteriorly located and more vulnerable to injury than those of the superficial peroneal branch. The clinical and electrodiagnostic findings in CPN resemble the anatomical structure of the common peroneal nerve, indeed fibers for the deep peroneal nerve and the superficial peroneal nerve are bounded in separate fascicles along the course of the nerve.
Superficial peroneal nerve sensory potential (SPSP) should be performed to localize the site of injury.
Electrodiagnostic testing is used widely to evaluate the function of the common peroneal nerve. SPSP have been examined in CPN with conflicting results. A loss in amplitude of this response implies some axonal loss affecting either the common peroneal nerve or its superficial branch. Prominent axonal loss is the hallmark of most CPN lesions and suggested that abnormalities in sensory nerves mirror those in motor nerves.
Moreover, assessment of the structure of the common peroneal nerve is likely to improve the diagnostic yield" by using high-resolution ultrasonography. Ultrasound imaging is painless, does not expose the patient to radiation, and has several advantages compared with magnetic resonance imaging in the laboratory setting, including reduced cost, accessibility, ability to image the entire length of the nerve in a single study, and the ability to image both statically and dynamically.
This study was conducted to evaluate the superficial peroneal sensory potential and high-resolution ultrasonography role in confirmation of common peroneal mononeuropathy at the fibular neck.
详细描述
The current study is a case control study that was done in the period from January 2015 to January 2016. The study included 70 participants presented with clinical and electrophysiological evidence of common peroneal neuropathy at the fibular neck (CPN) attending to Zagazig University Hospitals (Neurology, Rheumatology& Rehabilitation, and Orthopedic departments) and insurance hospitals of Sharkia governorate (47 male and 23 female). Their age (mean ± SD/years) was 40.4± 12.9, the duration between the onset of symptom and enrollment in the study ranged between 21 days to 6 months. Seventy (45 males and 25 females) apparently healthy volunteers were included as controls, and their age (mean ± SD/ years) was 41.3 ± 11.8. They were selected from the persons attending to blood bank for blood donation.
All participants included in the present study are subjected to:
- Full history taking.
- Thorough clinical and neurological examination.
- Routine laboratories tests for exclusion of other systemic affection like diabetes mellitus, renal or hepatic failure.
- Electrodiagnostic studies
All tests were done in the same room, at the time of clinical diagnosis using a Nicolet Viking Quest cart electrodiagnostic system. Lower extremity temperature was maintained at or above 30º C at time of examination. The electrophysiological studies included the following:
A-Motor nerve conduction studies:
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Other
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Participants were eligible for inclusion in the study if they had clinical and motor electrophysiological evidence suggesting common peroneal mononeuropathy at the fibular neck
- •Clinical evidence of common peroneal mononeuropathy at the fibular neck:
- •Numbness of the antero lateral aspect of the lower limb from about midway between the knee and the ankle, most of the dorsal aspect of the foot and toes and the web space between the first and second toes.
- •Weakness of the leg muscles innervated by the peroneal nerve. The strength of the tibialis anterior (TA), extensor hallucislongus (EHL), and peroneius longus muscles was tested using the Medical Research Council (MRC) rating scale.
- •Electrophysiological Motor localizing evidence of common peroneal mononeuropathy at the fibular neck:
- •Peroneal motor nerve conduction velocity decrement ≥10 m/s across the fibular neck segment; or focal conduction block, defined as compound motor action potential (CMAP) amplitude and area reduction ≥ 50% across the fibular neck segment.
排除标准
- •Participants were excluded if any of the following was detected:
- •Historical or clinical signs suggesting coexisting neurological conditions (e.g. polyneuropathy and motor neuropathy).
- •Foot drop with symptoms, signs or radiological findings of L5 radiculopathy in association with CPN.
- •Symptoms or signs suggesting systemic clinical illness like diabetes mellitus, renal failure, and hepatic failure.
- •Previous surgery for peroneal nerve.
结局指标
主要结局
is measuring the common peroneal nerve electrophysiological studies
时间窗: two week
measuring the common peroneal nerve senseromotor electrophysiological studies
is measuring the common peroneal nerve Ultrasonographical studies
时间窗: 1 week
measuring the common peroneal nerve Ultrasonographical cross sectional area
次要结局
未报告次要终点
研究者
rania sanad
Principal Investigator
Zagazig University