Shankar Vivek, Jyoti Nitish Jagdish, Dash Swayam Prakash, Sampath Kumar Venkatesan
Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
BMJ Case Rep. 2025 Jan 14;18(1):e261757. doi: 10.1136/bcr-2024-261757.
Slimmer's paralysis is a peripheral mononeuropathy of the common peroneal (fibular) nerve (CPN/CFN), typically associated with rapid weight loss resulting in loss of subcutaneous fat pad and subsequent neural compression at the fibular head. Here, we describe a young man with a 1-year history of right-sided foot drop, which developed following a rapid intentional weight loss of 11 kg over a period of 15 days. This weight loss was preceded by rapid weight gain over 2 days owing to binge eating. Laboratory parameters for systemic/metabolic disorders were unremarkable. Radiology of the lumbosacral spine was unremarkable. Confounding risk factors included high-intensity training, frequent squatting and stretching. Electrophysiological studies revealed common peroneal (fibular) neuropathy at the fibular head with persistent denervation. This case highlights the diagnostic dilemma between lumbosacral plexopathy/radiculopathy and common peroneal (fibular) neuropathy. Electrophysiological studies and radiological assessment of the lumbosacral spine suggest that neither CPN nor lumbosacral surgical decompression would be beneficial, emphasising the need for tendon transfer.
减肥者麻痹是一种腓总神经的周围性单神经病，通常与快速体重减轻有关，导致皮下脂肪垫丢失，随后在腓骨头处出现神经受压。在此，我们描述一名有1年右侧足下垂病史的年轻男性，其在15天内快速有意减重11kg后出现足下垂。在此次体重减轻之前，由于暴饮暴食，其在2天内体重快速增加。全身/代谢紊乱的实验室检查参数无异常。腰骶椎影像学检查无异常。混杂的危险因素包括高强度训练、频繁蹲坐和伸展。电生理研究显示腓骨头处腓总神经病变伴持续性失神经支配。该病例突出了腰骶丛病/神经根病与腓总神经病变之间的诊断困境。腰骶椎的电生理研究和影像学评估表明，腓总神经减压术和腰骶部手术减压均无益处，强调了肌腱转移的必要性。
