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Self-Assessment Questions

Neurology


Answer 6
  1. Pressure palsy (neurapraxia) of the right peroneal nerve. Weakness that is profound and discretely localized is the hallmark of a peripheral (lower motor neuron) process. Despite this patient’s multiple vascular risk factors, central nervous system lesions uncommonly affect only 1 limb and would be expected to produce more graded weakness in several limb muscle groups that do not conform to a specific peripheral nerve distribution. Peroneal neuropathies are common and are often seen from neurapraxia (compression damage) due to impingement of the peroneal nerve at the neck of the fibula, where it is most exposed. Prolonged leg crossing is one such mechanism. Sciatica can also cause foot drop, but it is accompanied by significant pain and often more diffuse weakness and sensory loss. Similarly, although an L5 radiculopathy could cause a similar pattern of weakness, an L5 compression fracture would be acutely painful.

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