Lateral popliteal nerve palsy, L4, L5 (common peroneal nerve palsy)

Published on 02/04/2015 by admin

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Last modified 02/04/2015

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75 Lateral popliteal nerve palsy, L4, L5 (common peroneal nerve palsy)

Instruction

Examine this patient’s legs.

Test this patient’s gait.

Salient features

History

• History of trauma to the nerve particularly when it winds around the neck of the fibula where it is protected by only skin and fascia

• Whether the symptoms occur after sitting crossed leg for prolonged periods

• Recent weight loss, particularly in those who have been confined to bed rest (nerve more vulnerable because the protective fat and muscle is lost)

• Plasters around the knee

• History of diabetes, polyarteritis nodosa, collagen vascular diseases (all causes of mononeuritis multiplex, p. 226).

Examination

• Wasting of the muscles on the lateral aspect of the leg, namely the peronei and tibialis anterior muscle

• Weakness of dorsiflexion and eversion of the foot

• Foot drop (Fig. 75.1A)

• High steppage gait (Fig. 75.1B)

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