Hackam D G, Zwimpfer T J
Division of Neurosurgery, University of British Columbia, Vancouver Canada.
Can J Neurol Sci. 1998 May;25(2):168-70. doi: 10.1017/s0317167100033813.
Presentation of an unusual case of congenital entrapment of the lateral cutaneous nerve of the calf (LCNC) mimicking a peroneal sensory neuropathy.
We report the case of as 16-year-old girl with a 3 year history of progressive tingling, numbness and pain in her right calf precipitated by athletic activities involving repeated flexion and extension of the knee. A Tinel's sign was present over the common peroneal nerve in the distal popliteal fossa but absent at the fibular neck. Motor and sensory examination of the common peroneal nerve was normal as were electrophysiological studies and MRI.
At surgery, the LCNC, a sensory branch of the common peroneal nerve, was entrapped at a point where it pierced the tendon of the biceps femoris muscle. Transection of the part of the tendon overlying the LCNC resulted in complete and permanent relief of symptoms.
The proximal location of the Tinel's sign, absence of motor or sensory deficits and normal electrophysiology suggested, preoperatively, that this was not an entrapment of the common peroneal nerve at the fibular neck but rather a more proximal abnormality likely involving only a part of the peroneal nerve or one of its sensory branches. As a result, the more proximal exposure of the peroneal nerve within the popliteal fossa revealed entrapment of the neuropathy of the common peroneal nerve or one of its branches, due to a normal nerve piercing an otherwise normal tendon. Secondly, there are no previously reported cases of surgically documented compression of the LCNC in an otherwise normal patient (i.e. non-diabetic).
介绍一例罕见的先天性小腿外侧皮神经（LCNC）卡压病例，该病例表现类似腓总感觉神经病变。
我们报告一名16岁女孩的病例，她在进行涉及膝关节反复屈伸的体育活动后，右小腿出现进行性刺痛、麻木和疼痛3年。在腘窝远端的腓总神经处有Tinel征，但在腓骨小头处未引出。腓总神经的运动和感觉检查正常，电生理研究和MRI检查也正常。
手术中发现，作为腓总神经感觉分支的LCNC在其穿过股二头肌肌腱处被卡压。切断覆盖在LCNC上的部分肌腱后，症状完全且永久缓解。
Tinel征的近端位置、无运动或感觉障碍以及正常的电生理检查结果，术前提示这并非腓总神经在腓骨小头处的卡压，而是更靠近近端的异常，可能仅涉及腓总神经的一部分或其感觉分支之一。因此，在腘窝内更靠近近端暴露腓总神经时，发现是由于正常神经穿过正常肌腱导致腓总神经或其分支之一的神经病变被卡压。其次，此前没有报道过在其他方面正常的患者（即非糖尿病患者）中经手术证实的LCNC受压病例。
