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absent fibular(peroneal) motor action potential with normal fibular (peroneal) activity

Chris Rink11/14/22 12:49 PM (CST)
Is there any situation where the fibular/peroneal CMAP and superficial fibular/peroneal SNAP can be absent normally? I was asked to evaluate a 22 y.o. for potential foot drop. he had an anoxic brain injury from an overdose with a prollonged period of low cognative and physical function, but has made a pretty profound recover. he has poor dorsiflexion of his right foot, but clinically this appears to be more related to a mild plantar flexion contracture than dorsifelxion weakness. on needle examination he had normal activity in the tibialis anterior, peroneous longus and ext. digitorm brevis. He has no sensory loss of the right calf or foot, but I was unable to obtain a fibular CMAP at the ankle, fibular head or proximal to the fibular head. At the time, I did not think to get a CMAP from the T.A. Before I bring him back to test for a fibular response to the T.A., I wanted to see if it possible to be unable to obtain a fibular response to the EDB without some sort of pathology. he did have a normal fibular CMAP on the left.
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