*Department of Orthopedics and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.
†Department of Physical Therapy and Rehabilitation, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.
J Am Podiatr Med Assoc. 2024 Sep-Oct;114(5). doi: 10.7547/22-080.
We evaluated patients who were followed after acutely developing single-sided footdrop and improving with conservative management or spontaneously.
In 2019 and 2020, ten patients were retrospectively evaluated for unilateral weakness of the lower extremity in the form of absent dorsiflexion at the ankle joint and were given a diagnosis of footdrop without etiologic cause. Patients were followed for 18 months. Patients were evaluated for acute footdrop of the affected extremity with electromyography, lumbar spine magnetic resonance imaging (MRI), knee MRI, peripheral MRI neurography, and noncontrast brain MRI. Each patient was evaluated for a history of COVID-19 infection during the past year. Patients with any identified cause were excluded.
Initial evaluation of muscle strength revealed 0/5 by the Medical Research Council muscle testing scale. In two patients, muscle strength was 3/5 at month 6 and in eight patients it was 4/5. Muscle strength of all of the patients improved to 5/5 at 1 year. Six patients were dispensed an ankle-foot orthosis, and nine patients performed physical therapy. Electromyography identified significant neuropathy at the level of the common peroneal at the fibular head in all of the patients. Compared with peroneal nerve stimulation below and above the fibular head in the lateral popliteal fossa, a 50% reduction in sensory amplitude and motor conduction slowing greater than 10 m/sec were present. Knee MRI revealed no masses, edema, or anatomical variations at the level of the fibular head.
Spontaneous resolution of unilateral acute footdrop without an etiologic cause can occur within 1 year.
我们评估了急性单侧足下垂患者，这些患者经保守治疗或自发改善后进行了随访。
在 2019 年和 2020 年，回顾性评估了 10 例以踝关节背屈缺失为表现的单侧下肢无力的患者，并诊断为病因不明的足下垂。患者随访 18 个月。通过肌电图、腰椎 MRI、膝关节 MRI、周围 MRI 神经图和非对比脑 MRI 评估受累肢体的急性足下垂。每位患者均评估过去一年是否有 COVID-19 感染史。排除有任何明确病因的患者。
最初的肌力评估显示，按医学研究委员会肌肉测试量表评分，患者肌力为 0/5。6 个月时有 2 例患者肌力为 3/5，8 例患者肌力为 4/5。所有患者的肌力在 1 年内均提高至 5/5。6 例患者配带踝足矫形器，9 例患者接受物理治疗。肌电图在所有患者中均发现腓骨头水平的腓总神经有明显的神经病变。与腓骨小头外侧腓总神经的刺激相比，感觉幅度降低 50%，运动传导速度减慢超过 10 m/sec。膝关节 MRI 显示腓骨头水平无肿块、水肿或解剖变异。
无病因的单侧急性足下垂可在 1 年内自发缓解。
