Ciacci G, Federico A, Giannini F, Mondelli M, Reale F, Rossi A
Ital J Neurol Sci. 1986 Jun;7(3):377-80. doi: 10.1007/BF02340878.
We report the case of a 41 year old man who complained of a severe bilateral deficit of the anterior tibial compartment two hours after prolonged exercise. On admission there was no spontaneous or evoked pain, no objective sensory deficit but total loss of dorsiflexion of feet and toes. Electrophysiological investigation showed no voluntary or evoked electrical activity in tibial and extensor digitorum muscles; while peroneus longus and gastrocnemius muscles showed a near-normal pattern. On the other hand a weak motor response was obtained by direct stimulation of the anterior tibial muscle belly. An early bilateral fasciotomy was followed by almost complete recovery of the spontaneous and evoked motor activities of the tibial anterior muscles. On the basis of these findings we discuss the possible pathogenetic role of a neuroapraxic block of the deep peroneal nerve where it crosses the anterior fibular septum and supply a possible interpretation of the absence of pain.
我们报告了一例41岁男性病例，该患者在长时间运动两小时后出现双侧胫前肌严重功能缺失。入院时，无自发痛或诱发性疼痛，无客观感觉缺失，但足背屈和趾背屈完全丧失。电生理检查显示，胫肌和趾长伸肌无自主或诱发性电活动；而腓骨长肌和腓肠肌显示接近正常模式。另一方面，直接刺激胫前肌肌腹可获得微弱的运动反应。早期双侧筋膜切开术后，胫前肌的自发和诱发运动活动几乎完全恢复。基于这些发现，我们讨论了腓深神经在穿过腓骨前间隔处发生神经失用性阻滞的可能致病作用，并对无疼痛现象提供了一种可能的解释。
