Shahar Eli, Landau Ella, Genizi Jacob
Child Neurology Unit, Rambam Medical Center, Rappaport School of Medicine, Haifa, Israel.
Eur J Paediatr Neurol. 2007 Jan;11(1):50-4. doi: 10.1016/j.ejpn.2006.10.008. Epub 2006 Dec 12.
We report herein an uncommon presentation of peroneal nerve palsy and possible myelopathy in an adolescent associated with marked uncontrolled weight loss during a relatively short period.
He presented with left drop foot accompanied with sensory impairment at the foot dorsum. Neurophysiologic studies revealed a severe neuropathy of the left peroneal nerve with evidence of a conduction block at the left fibular head suggestive of entrapment neuropathy.
As for the underlying etiology of acute peroneal neuropathy (PN) and possible myelopathy associated with marked weight loss, it has been suggested that rapid loss of the subcutaneous tissue may lead to entrapment of the peroneal nerve at the fibular head leading to foot drop. Body fat percentage was found remarkably low for age at 10% (normal value for age for males: 22.3%) indicative of massive rapid weight reduction markedly depleting fat stores.
When an adolescent presents with acute foot drop, PN associated with rapid uncontrolled weight reduction should be taken into account. Prompt resumption of a balanced diet including vital nutritional ingredients may avoid permanent neurological damage and probably assist in recovery from severe flaccid weakness of the lower extremity.
我们在此报告一名青少年腓总神经麻痹及可能的脊髓病的罕见表现，其在相对较短的时间内伴有明显的体重失控减轻。
他表现为左足下垂，伴有足背感觉障碍。神经生理学研究显示左侧腓总神经严重神经病变，在左腓骨头处有传导阻滞的证据，提示为卡压性神经病变。
至于急性腓总神经病变（PN）及与明显体重减轻相关的可能脊髓病的潜在病因，有人提出皮下组织的快速丢失可能导致腓总神经在腓骨头处受压，从而导致足下垂。发现其体脂百分比按年龄算极低，为10%（男性年龄正常值：22.3%），表明体重大量快速减轻，脂肪储备明显消耗。
当青少年出现急性足下垂时，应考虑与快速体重失控减轻相关的PN。迅速恢复包含重要营养成分的均衡饮食可避免永久性神经损伤，并可能有助于从下肢严重弛缓性无力中恢复。
