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Bilateral peroneal neuropathy
I have a 72 y/o patient who presented to EMG for my colleague with
weakness of both legs. EMG is showing absent superficial peroneal bilaterally. Sural is 5.5 bilaterally. Peroneal motor amplitudes were 1.4 and 1.2 going down to 0.7 bilaterally with no slowing across the knees .
abnormal muscles on needling are TA, PL, EHL.
everything else is normal.
brought her in for a full Neuro exam. Only dorsiflexion, eversion and big toe extension are weak. Sensation diminished on dorsum of the feet only.
Mri of the knees showed faint edema with no atrophy of the TA
of note , she had bilateral injection in both knees for pain just before this started (medial approach)
Just not comfortable with all of sudden, bilateral painless peroneal neuropathy.
ALS ruled out. Needling everywhere, negative. No other weakness or symptoms
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