Subscribe to RSS
DOI: 10.1186/1749-7221-6-3
Prevalence of accessory deep peroneal nerve in referred patients to an electrodiagnostic medicine clinic[*]
Subject Editor:
Publication History
15 September 2010
08 July 2011
Publication Date:
23 September 2014 (online)
Abstract
Background Accessory Deep Peroneal Nerve (ADPN) is an anatomic variation that can potentially cause disturbance in electrodiagnostic studies. This anomaly could be detected by nerve conduction studies. There are no recent updates about prevalence of this anatomic variation. Electrodiagnostic medicine clinic is the best environment for detecting presence and prevalence of this nerve, so present study enrolled.
Materials & Methods In this cross sectional descriptive study that take place from March 2009 to July 2010, 230 cases comprising 460 legs referred for electrodiagnostic studies of upper limbs problems participated in the study. Compound muscle action potential (CMAP) and Nerve conduction Velocity (NCV) of Deep Peroneal Nerve (DPN) were measured by using EMG machine by stimulating DPN at knee, ankle and lateral malleolous areas accordingly, with recording from extensor digitorum brevis muscle. Results were analyzed and conclusion made.
Results The study population included 120 females (52%) and 110 (47%) males with mean age of 42.1 ± 13.5 years. ADPN was detected in 28 patients (12%). Among them,10(17.9%) had bilateral ADPN and in remained 18 cases (82.1%) APN was unilateral. In 8 patients there was no recorded CMAP from EDB by proximal and distal stimulation implying EDB agenesis. Gender distribution was similar which means half of the cases (14 patients) belonged to each gender.
Conclusion The prevalence of ADPN in this study was 12.2%, (17.9% bilateral and 82.1% unilateral).
*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.
-
References
- 1 Dumitru D, Amato AA, Zwarts MJ. Electrodiagnostic medicine. Hanley & Belfus San Antonio; Texas: 2002
- 2 Kayal R, Katirji B In Atypical deep peroneal neuropathy in the setting of an accessory deep peroneal nerve. Muscle & Nerve 2009; 40 (2) 313-315
- 3 DeLisa JA. manul of nerve conduction study clinical nerouphysiology. raven press; new york: 3rd edition 1994
- 4 Knoll AN. Nerve Anatomy and Entrapment Neuropathies of the Lower 2010;
- 5 Masakado Y. Clinical neurophysiology in the diagnosis of peroneal nerve palsy. The Keio Journal of Medicine 2008; 57 (2) 84-89 10.2302/kjm.57.84 18677088
- 6 Owsiak S, Kostera-Pruszczyk A. Accessory deep peroneal nerve-a clinically significant anomaly?. Neurologia i neurochirurgia polska 2008; 42 (2) 112-115 18512167
- 7 Kuruvilla A. Accessory deep peroneal nerve. Neurology India 2004; 52 (1) 135-135 15069275
- 8 Andresen B, Wertsch J, Stewart W. Anterior tarsal tunnel syndrome. Archives of physical medicine and rehabilitation 1992; 73 (11) 1112-1117 1444780
- 9 Krause KH, Witt T, Ross A. The anterior tarsal tunnel syndrome. Journal of neurology 1977; 217 (1) 67-74 10.1007/BF00316318 75254
- 10 Posa HNRM. deep peroneal sensory neuropathy. Muscle & Nerve 1992; 15: 745-746 21739664
- 11 Mathis S. Study of accessory deep peroneal nerve motor conduction in a population of healthy subjects. Neurophysiologie Clinique/Clinical Neurophysiology 2011; 214-215
- 12 Bhardwaj AK. Anatomic variations of superficial peroneal nerve: clinical implications of a cadaver study. Italian Journal of Anatomy and Embryology 2010; 115 (3) 223-228 21287977
- 13 Ubogu EE. Complete innervation of extensor digitorum brevis by accessory peroneal nerve. Neuromuscular Disorders 2005; 15 (8) 562-564 10.1016/j.nmd.2005.04.004 15935667
- 14 Murad H, Neal P, Katirji B. Total innervation of the extensor digitorum brevis by the accessory deep peroneal nerve. European Journal of Neurology 1999; 6 (3) 371-373 10.1046/j.1468-1331.1999.630371.x 10210922
- 15 Kudoh H, Sakai T, Horiguchi M. The consistent presence of the human accessory deep peroneal nerve. Journal of anatomy 1999; 194 (1) 101-108 10.1046/j.1469-7580.1999.19410101.x 1467898 10227671
- 16 Hasegawa OMS, Wada N. innervation patterrn to the extensor digirtorum brevis by deep peroneal nerve and accessory deep peroneal nerve. No To Shinkei 2001; 53: 453-456 11424356
- 17 Marciniak C. Practice parameter: Utility of electrodiagnostic techniques in evaluating patients with suspected peroneal neuropathy: An evidence based review. Muscle & Nerve 2005; 31 (4) 520-527 10.1002/mus.20308 21739664
- 18 Posa HNRM. nerve conduction studies of the medial branch of deep peroneal nerve. Muscle & Nerve 1990; 13: 862 21739664