Eguchi Katsuki, Shirai Shinichi, Iwata Ikuko, Matsushima Masaaki, Yabe Ichiro
Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University.
Rinsho Shinkeigaku. 2020 Aug 7;60(8):549-553. doi: 10.5692/clinicalneurol.60.cn-001422. Epub 2020 Jul 7.
A 39-year-old man presented with an 8-month history of pain and paresthesia of the right foot sole and difficulty in the right toe dorsiflexion. A neurological examination revealed weakness in performing both the ankle and right foot toe dorsiflexion, reduced right planta pedis sensation, and absent right Achilles tendon reflex. Tinel's sign was present on the right popliteal fossa and medial part of the right ankle. MRI of the right knee showed multiple cystic lesions in his right tibial nerve. The cystic lesions extended from the popliteal fossa and were thought to be intraneural ganglion cysts. On MRI performed 4 months later, most of the cystic lesions spontaneously vanished. Therefore, intraneural ganglia should be considered when atypical mononeuropathy, such as tibial nerve palsy, is present.
一名39岁男性，有8个月右足底疼痛、感觉异常及右足趾背屈困难的病史。神经系统检查发现，患者在进行踝关节和右足趾背屈时均有无力表现，右足底感觉减退，右跟腱反射消失。右侧腘窝和右踝内侧有Tinel征。右膝MRI显示右侧胫神经有多个囊性病变。这些囊性病变从腘窝延伸，被认为是神经内腱鞘囊肿。4个月后进行的MRI检查显示，大多数囊性病变自发消失。因此，当出现非典型单神经病，如胫神经麻痹时，应考虑神经内腱鞘囊肿。
