Shields Lisa B E, Iyer Vasudeva G, Shields Christopher B, Zhang Yi Ping, Rao Abigail J
Norton Neuroscience Institute, Norton Healthcare, Louisville, Kentucky, USA.
Neurodiagnostic Center of Louisville, Louisville, Kentucky, USA.
Case Rep Neurol. 2021 Aug 19;13(2):555-564. doi: 10.1159/000518377. eCollection 2021 May-Aug.
Slimmer's paralysis refers to a common fibular nerve palsy caused by significant and rapid weight loss. This condition usually results from entrapment of the common fibular nerve due to loss of the fat pad surrounding the fibular head. Several etiologies of common fibular nerve palsy have been proposed, including trauma, surgical complications, improperly fitted casts or braces, tumors and cysts, metabolic syndromes, and positional factors. We present 5 cases of slimmer's paralysis in patients who had lost 32-57 kg in approximately 1 year. In 2 cases, MR neurogram of the knee demonstrated abnormalities of the common fibular nerve at the fibular head. Two patients underwent a common fibular nerve decompression at the fibular head and attained improved gait and sensorimotor function. Weight loss, diabetes mellitus, and immobilization may have contributed to slimmer's paralysis in 1 case. Awareness of slimmer's paralysis in patients who have lost a significant amount of weight in a short period of time is imperative to detect and treat a fibular nerve neuropathy that may ensue.
减肥者麻痹是指因显著且快速的体重减轻导致的一种常见腓总神经麻痹。这种情况通常是由于腓骨头周围脂肪垫缺失致使腓总神经受压所致。腓总神经麻痹有多种病因，包括创伤、手术并发症、石膏或支具佩戴不当、肿瘤和囊肿、代谢综合征以及体位因素。我们报告了5例减肥者麻痹患者，这些患者在大约1年内体重减轻了32至57千克。其中2例患者的膝关节磁共振神经成像显示腓骨头处腓总神经异常。2例患者接受了腓骨头处的腓总神经减压术，步态及感觉运动功能得到改善。1例患者的减肥、糖尿病和固定不动可能促成了减肥者麻痹。对于在短时间内体重显著减轻的患者，必须提高对减肥者麻痹的认识，以便检测并治疗可能随之发生的腓神经病变。
