Cucu Laura-Elena, Popescu Gabriela, Maștaleru Alexandra, Ignat Emilian Bogdan, Grosu Cristina, Bîrsanu Lenuța, Leon Maria Magdalena
Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Clinical Rehabilitation Hospital, 700661 Iași, Romania.
Nutrients. 2025 May 24;17(11):1782. doi: 10.3390/nu17111782.
Common peroneal nerve neuropathy at the fibular head secondary to weight loss is known as slimmer's paralysis. Although this pathology has long been documented in medical literature, it has gained more clinical significance in recent years due to the global rise in obesity and the increasing pursuit of rapid weight loss methods. While case reports exist in the current literature, there are limited data regarding its optimal management. This study summarizes all reported cases of common peroneal nerve paralysis after weight loss and reports one additional case, exploring disease mechanisms as well as diagnostic and therapeutic strategies. A literature review was conducted on the platforms PubMed, Google Scholar, and EMBASE. A total of 380 patients were included. Laterality of neuropathy was specified in 297 (78.16%) patients: 285 (95.96%) with unilateral neuropathy and 12 (4.04%) with bilateral neuropathy. A total of 19 (5.00%) patients had sudden onset, and in 145 (38.16%) of cases, the Tinel's sign was positive. Additionally, 373 (98.16%) patients underwent nerve conduction studies, demonstrating the fibular head as the site of injury. MRI or ultrasound imaging of the knee is indicated to exclude compressive etiology. A total of 302 (79.47%) cases were treated surgically and 42 (11.58%) conservatively, predominantly with favorable outcomes, regardless of the therapeutic approach chosen. Although the predominance of surgically treated cases in the literature limits definitive treatment recommendations, conservative management appears appropriate when an extended recovery time is acceptable, while surgical decompression is indicated in cases showing no improvement after 3 months.
因体重减轻继发于腓骨头处的腓总神经病变被称为减肥者麻痹。尽管这种病理情况在医学文献中早有记载，但近年来由于全球肥胖率上升以及对快速减肥方法的追求增加，它具有了更大的临床意义。虽然当前文献中有病例报告，但关于其最佳治疗方法的数据有限。本研究总结了所有已报道的减肥后腓总神经麻痹病例，并报告了另外一例，探讨了疾病机制以及诊断和治疗策略。在PubMed、谷歌学术和EMBASE平台上进行了文献综述。共纳入380例患者。297例（78.16%）患者明确了神经病变的部位：285例（95.96%）为单侧神经病变，12例（4.04%）为双侧神经病变。共有19例（5.00%）患者突然起病，145例（38.16%）病例的Tinel征呈阳性。此外，373例（98.16%）患者接受了神经传导研究，显示损伤部位在腓骨头。建议进行膝关节的MRI或超声成像以排除压迫性病因。共有302例（79.47%）病例接受了手术治疗，42例（11.58%）接受了保守治疗，无论选择何种治疗方法，大多数患者预后良好。尽管文献中手术治疗病例占主导地位限制了明确的治疗建议，但当可接受较长的恢复时间时，保守治疗似乎是合适的，而在3个月后无改善的病例中则应进行手术减压。
