Occupational neuropathy of the sural nerve

Abstract

A 20-year-old carpet-layer with compression of the right sural nerve due to the peculiar posture maintained during his work is described, and electromyographic findings are presented.

Fascial entrapment of the sural nerve and its clinical relevance

“…Intrinsic causes, such as ganglions and lipomas [1, 3], as well as prolonged external compression by heel straps [2], positioning [6, 7], repetitive ankle sprains [2], fractures of the area [8] and gastrocnemius muscle injury [6, 7] may eventually lead to SN lesion. However, entrapment of the SN is mainly caused by compression and fixation of the nerve due to fascial thickening [3].…”

“…It is uncertain whether imaging techniques or electrodiagnostic studies can assist in establishing the diagnosis [2]. Doppler studies, ultrasonography, computed tomography or magnetic resonance imaging scanning may assist in visualization of the entrapment site, whereas increase in distal latency and decrease in amplitude of the sensory action potential of SN could indicate long-termed SN entrapment neuropathy [2, 6]. Moreover, injections with local anesthetic in the area of tenderness can lead to temporary resolution of the symptoms, representing an additional diagnostic tool [2].…”

Sural neuropathy: Etiologies and predisposing factors

“…A search of our database containing over 50,000 electrodiagnostic studies resulted in the 36 cases of sural neuropathy described herein, which represents the largest reported sample of sural mononeuropathies, at least to our knowledge. Trauma is the most frequently cited cause of sural neuropathy in the literature and neuropathies secondary to ankle fracture,10, 16, 24 trauma,4, 7, 18, 20, 21, 24 and external compression at the ankle have been reported 2, 5, 11, 19, 22, 24. Structural lesions secondary to Baker's cyst15 and intraneural ganglions1, 17 have also been reported.…”

“…Trauma is the most frequently cited cause of sural neuropathy in the literature and neuropathies secondary to ankle fracture, 10,16,24 trauma, 4,7,18,20,21,24 and external compression at the ankle have been reported. 2,5,11,19,22,24 Structural lesions secondary to Baker's cyst 15 and intraneural ganglions 1,17 have also been reported. Sural neuropathy is also an uncommon complication of ankle surgery, and cases similar to our vein-stripping neuropathy 14,24,26 and neuropathy following sural harvesting for nerve graft 25 have been reported.…”