Superficial peroneal nerve syndrome: an unusual nerve entrapment

Case report

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✓Lower-extremity pain and paresthesia have multiple origins. Early recognition of the symptoms of peripheral nerve entrapment leads to timely treatment and avoids the cost of unnecessary studies. The authors report on a case of superficial peroneal nerve syndrome resulting from nerve herniation through a fascial defect, which was responsive to surgical treatment.

This 22-year-old man presented with pain and paresthesias over the lateral aspect of the right calf and the dorsum of the foot without motor weakness. Exercise led to the formation of a tender bulge approximately 12 cm above the lateral malleolus. Percussion of this site worsened his symptoms. Radiography and electromyography studies were nondiagnostic. The patient underwent surgical decompression that involved division of the fascia overlying the nerve and neurolysis of the superficial peroneal nerve. The operation resulted in symptom-free relief.

Superficial peroneal nerve syndrome is an entrapment neuropathy that results from mechanical compression of the nerve at or near the point where the nerve pierces the fascia to travel within the subcutaneous tissue. Surgical decompression of the mechanical entrapment usually provides relief from pain and paresthesia.

Abbreviation used in this paper:EMG = electromyography.

Article Information

Address reprint requests to: John E. McGillicuddy, M.D., Department of Neurosurgery, University of Michigan Health System, 1500 East Medical Center Drive, Room 3552 TC, Ann Arbor, Michigan 48109-0338. email: jemc@med.umich.edu.

© AANS, except where prohibited by US copyright law.

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Figures

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    Photograph depicting the protrusion of fatty tissue through a fascial defect, with the superficial peroneal nerve exiting through fascia approximately 10 cm above the lateral malleolus.

  • View in gallery

    Left: Photograph depicting a partially decompressed superficial peroneal nerve after transection of the distal fascia. Right: Photograph showing a fully decompressed superficial peroneal nerve after transection of the proximal fascia.

  • View in gallery

    Photograph showing fatty infiltration of the nerve precluding complete neurolysis.

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