Open Access
J Brachial Plex Peripher Nerve Inj 2008; 03(01): e69-e74
DOI: 10.1186/1749-7221-3-24
Research article
Papagianni et al; licensee BioMed Central Ltd.

Clinical and neurophysiological study of peroneal nerve mononeuropathy after substantial weight loss in patients suffering from major depressive and schizophrenic disorder: Suggestions on patients’ management[*]

Aikaterini Papagianni
†   Equal contributors
1   Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece
,
Panagiotis Oulis
†   Equal contributors
2   Department of Psychiatry, Aeginition Hospital, Medical School, University of Athens, Greece
,
Thomas Zambelis
†   Equal contributors
1   Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece
,
Panagiotis Kokotis
†   Equal contributors
1   Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece
,
George C Koulouris
†   Equal contributors
2   Department of Psychiatry, Aeginition Hospital, Medical School, University of Athens, Greece
,
Nikos Karandreas
†   Equal contributors
1   Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece
› Author Affiliations

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Further Information

Publication History

19 May 2008

12 November 2008

Publication Date:
17 September 2014 (online)

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Abstract

Background Peroneal nerve is susceptible to injuries due to its anatomical course. Excessive weight loss, which reduces the fatty cushion protecting the nerve, is considered a common underlying cause of peroneal palsy. Other predisposing factors, such as prolonged postures, traumas of the region or concomitant pathologies (for example diabetes mellitus) contribute to the nerve damage. This study aims to reveal the multiple predisposing factors of peroneal nerve mononeuropathy after substantial weight loss that coexist in psychiatric patients and to make suggestions on their management.

Methods Nine psychiatric inpatients, major depressive or schizophrenic, with foot drop underwent a complete clinical neurological and neurophysiological examination. All had excessive weight loss, which was completed in a short period of time and had not resulted from a well-balanced low-calorie diet, but was due to their psychiatric illness. Data regarding predisposing factors to peroneal nerve mononeuropathy were gathered, such as habitual leg crossing, squatting or other prolonged postures.

Results The clinical examination and the neurophysiological evaluation in all patients were indicative of a focal lesion of the peroneal nerve at the fibular head.

Conclusion Patients with major depressive and schizophrenic disorders gather multiple predisposing factors to peroneal palsy, adequate to classify them at a high risk group. The better focus of the attendant medical and nursing staff on this condition, the early clinical and neurophysiologic evaluation and surgical interventions may enable an improved management and prognosis of these patients.

*This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.