Differential diagnosis of peroneal nerve palsy – case presentation

Peroneal nerve palsy is the most common form of compression neuropathy of the lower limb, presenting with limited dorsal flexion of the foot with or without sensory symptoms. The etiology is variable, with nerve compression being the leading cause. The most common cases of peroneal palsy happen after trauma, surgical interventions in the foot and knee area, as well as compression of the nerve after prolonged lying of the patient in one posture, after immobilization, or after prolonged kneeling or staying with crossed legs, especially after significant weight loss. Peroneal nerve palsy is seen in various polyneuropathies, with peroneal paresis being one of the most common initial presentations in hereditary neuropathy with pressure palsies (HNPP).We present the cases of patients, that illustrate the different etiologies of peroneal nerve palsy – a case of a girl with peroneal paresis after trauma of the foot, a case of a boy with peroneal paresis after prolonged lying in one posture, leading to a compression of the nerve and a case of peroneal palsy in a girl with significant weight loss. In the last case, the positive family history, the slow improvement in the clinical picture, as well as the results of the electrophysiological study, which showed involvement of other nerves during the acute onset of the peroneal monoparesis, were suggestive for the diagnosis of HNPP.