Common Peroneal Nerve Palsy

Please examine the lower limbs of this 55 year old lady who has been referred
by her GP with difficulty walking

Clinical Examination:

Classical Signs Additional Signs

- Foot drop - Sensory loss over the lateral calf

- Wasting of the lateral muscles of the and dorsum of the foot
lower leg - Clinical features of Diabetes or
- Weakness of dorsiflexion of the foot Vasculitis
- Weakness of eversion
- Weakness of toe extension
- High stepping gait
- Intact ankle reflex
Common discussion topics:
Root supply and muscles of the common peroneal nerve
Causes of common peroneal nerve injury
Investigations

Quick Revision:
Root supply: L4, L5, S1 Muscles supplied: L4, L5 – tibialis anterior
(dorsiflexion). L5, S1 – Peroneus longus, peroneus brevis (eversion)

Causes Investigations

- Compression injuries (eg plasters)

where the common peroneal nerve
twines round the neck of fibula.
- Other causes of a peripheral
neuropathy - eg diabetes,
vasculitis
- X-rays
- Nerve conduction studies
- Investigations for other causes of
peripheral neuropathy