Stewart John D
Lions Gate Hospital, North Vancouver, British Columbia, Canada.
Pract Neurol. 2008 Jun;8(3):158-69. doi: 10.1136/jnnp.2008.149393.
Foot drop is a common and distressing problem that can lead to falls and injury. Although the most frequent cause is a (common) peroneal neuropathy at the neck of the fibula, other causes include anterior horn cell disease, lumbar plexopathies, L5 radiculopathy and partial sciatic neuropathy. And even when the nerve lesion is clearly at the fibular neck there are a variety of causes that may not be immediately obvious; habitual leg crossing may well be the most frequent cause and most patients improve when they stop this habit. A meticulous neurological evaluation goes a long way to ascertain the site of the lesion. Nerve conduction and electromyographic studies are useful adjuncts in localising the site of injury, establishing the degree of damage and predicting the degree of recovery. Imaging is important in establishing the cause of foot drop be it at the level of the spine, along the course of the sciatic nerve or in the popliteal fossa; ultrasonography, CT and MR imaging are all useful. For patients with a severe foot drop of any cause, an ankle foot orthosis is a helpful device that enables them to walk better and more safely.
足下垂是一个常见且令人苦恼的问题，可能导致跌倒和受伤。尽管最常见的原因是腓骨小头处的（常见）腓总神经病变，但其他原因包括前角细胞疾病、腰丛病变、L5神经根病和部分坐骨神经病变。而且，即使神经病变明显位于腓骨颈部，也有多种原因可能并不立即明显；习惯性交叉双腿很可能是最常见的原因，大多数患者停止这种习惯后病情会改善。细致的神经学评估对于确定病变部位大有帮助。神经传导和肌电图检查有助于定位损伤部位、确定损伤程度并预测恢复程度。影像学检查对于确定足下垂的病因很重要，无论是在脊柱水平、沿坐骨神经走行还是在腘窝处；超声、CT和磁共振成像都很有用。对于任何原因导致的严重足下垂患者，踝足矫形器是一种有用的器械，可使他们行走得更好、更安全。
