Electrodiagnostic signatures of lower-limb nerve dysfunction in children with spina bifida: A retrospective case-control study

Peripheral‐nerve abnormalities contribute to lower-limb disability in children diagnosed with spina bifida, yet paediatric, norm-referenced electrodiagnostic data are scarce. This study characterized lower-limb nerve-conduction deviations in this population. We performed a single-centre retrospective case-control review of lower-limb nerve-conduction studies (NCS) performed between January 2019 and January 2024. Sixteen children with clinically or image-confirmed spina bifida met the inclusion criteria. Distal latency, conduction velocity and amplitude of the common peroneal, tibial and sural nerves were all recorded using the American Clinical Neurophysiology Society guidelines. Values were compared with age-matched paediatric norms via Wilcoxon signed-rank testing (α = 0.05). A total of 16 patients were included. Peroneal compound muscle-action-potential (CMAP) amplitudes were significantly reduced bilaterally versus norms (median difference right − 1.9 mV, p = 0.003; left − 1.7 mV, p = 0.001), whereas distal latency and velocity were preserved. Sural nerves exhibited prolonged distal latency on both sides (right -1.0 ms, p = 0.001; left -1.01 ms, p = 0.01) without any amplitude or velocity change. No significant differences were observed in any tibial nerve parameters. All subjects generated recordable motor and sensory responses. Children diagnosed with spina bifida demonstrate a characteristic electrodiagnostic profile—attenuated peroneal CMAP combined with isolated sural latency prolongation—suggesting distal axonal loss and focal demyelination of selected lower-extremity nerves. However, the cross-sectional design and lack of functional assessment limit the prognostic value of the characteristics. Future research focused on the correlation of longitudinal NCS parameters and functional outcomes should be warranted.