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Fulltext Case observation on the common peroneal nerve injury

Myint K

Med J Malaysia, 1980 Jun;34(4):368-9.
PMID: 7219265

The peculiar anatomical features render the common peroneal nerve particularly susceptible to injury at the knee. The present investigation revealed that the deep division of the nerve is more inclined to be injured when compared to the superficial division.

Matched MeSH terms: Peroneal Nerve/injuries*
Fulltext Comparison of nerve graft and artificial conduits for bridging nerve defects

Azhar MM, Sara TA

Med J Malaysia, 2004 Dec;59(5):578-84.
PMID: 15889558

A study of nerve regeneration through a 1cm defect in the peroneal component of the sciatic nerve was performed on sixteen rabbits. Either silicone or polytetrafluoroethylene (PTFE) tubes or nerve graft were used to bridge the defect and the opposite limb was not operated upon. The rabbits that underwent nerve grafting had favourable findings. In the PTFE group, a nerve-like structure was seen at the former gap site and histology confirmed viable axons within the tubes and distal to the repair site. In the silicone tube group, there were no myelinated axons demonstrated. The axonal count for the grafted nerves and the nerves repaired with PTFE tube are on average 80.4% and 38.2% of that of the unoperated nerve, respectively. On average, the percentage anterior compartment muscle weight (expressed as a percentage of the unoperated limb) for the silicone, PTFE and nerve graft groups are 42.3%, 42.1%, and 72.7% respectively. The results show that although, PTFE conduits can bridge a nerve defect of 1cm, nerve grafting provides a superior and more predictable outcome.

Matched MeSH terms: Peroneal Nerve/injuries*; Peroneal Nerve/physiopathology; Peroneal Nerve/surgery*
Fulltext Common peroneal nerve palsy due to posterolateral displacement of fractured lateral tibial plateau

Myint K, Iqbal QM, Kanagasuntheram R

Med J Malaysia, 1980 Sep;35(1):61-3.
PMID: 7254001

Numerous aetiopathologic factors have been enumerated as the possible causes of injuries to the common peroneal nerve at knee. This report presents a case of postero-lateral displacement of the upper end of fibula consequent to the displacement of fractured lateral tibial plateau leading to common peroneal nerve palsy which has not been reported before.

Matched MeSH terms: Peroneal Nerve/injuries*
Sensory, motor and sympathetic neurons forming the common peroneal and tibial nerves in the macaque monkey (Macaca fascicularis)

Janjua MZ, Leong SK

J Anat, 1987 Aug;153:63-76.
PMID: 3429328

The motoneurons, dorsal root ganglion (DRG) and sympathetic ganglion (SG) cells forming the common peroneal (CPN) and tibial (TN) nerves of young and semiadult monkeys (Macaca fascicularis) were localised by the horseradish peroxidase method of tracing neuronal connections. The motoneurons forming the CPN occur in the L4-L6 segments, appearing as 1-3 groups and occupying the retroposterolateral (rpl), posterolateral (pl) and central (c) groups of motor nuclei. The motoneurons forming the TN occur in the L4-L7 segments, appearing as 1-4 groups and occupying the rpl, pl, c and anterolateral (al) groups. The motoneurons and DRG cells forming the CPN show peak frequencies at the L5 level, and the SG cells forming the same nerve, at the L6 level in most cases. The motoneurons and DRG cells forming the TN show peak frequencies at the L6 level and the SG cells forming the same nerve, also at the L6 level in most cases. The bulk of motoneurons, DRG and SG cells forming the CPN and TN are concentrated in two segmental levels. For CPN the motoneurons measure between 14-76 micron in their average somal diameters and for TN, 16-70 micron. The majority of them (65.5% for CPN motoneurons and 72% for TN motoneurons) have average somal diameters greater than 38 micron. The size spectrum of the DRG cells forming the CPN is similar to that of DRG cells forming the TN, being 12-78 micron for CPN and 10-76 micron for TN. The sympathetic neurons forming the CPN (measuring 10-44 micron) have a larger size spectrum than those forming the TN (measuring 6-33 micron). The diameter spectrum (3-20 micron for TN and 2-19 micron for CPN) and peak frequency distributions (10 micron for both TN and CPN) of the myelinated fibres present in the CPN and TN are also similar, with the CPN fibres skewing towards a slightly larger size. Many of the fibres in the young and semi-adult monkeys are not yet myelinated.

Matched MeSH terms: Peroneal Nerve/anatomy & histology*
Organization of common peroneal nerve motoneurones in the rat and monkey: a comparative study

Yeong SO, Subramaniam K, Vrbová G

Neuroreport, 1998 Apr 20;9(6):1085-8.
PMID: 9601672

The motoneurones with axons in the common peroneal nerve (CPN) of the rat and monkey were examined using retrograde labelling with horseradish peroxidase (HRP). In both species, the CPN motoneurone pool was localized in the dorsolateral part of the ventral horn of the spinal cord. In the rat, the labelled motoneurones were located between the L3 and L6 spinal segments whereas in the monkey, they extended from the caudal end of L4 to the L6 spinal segments. In both species the majority of the labelled neurones were located within the L5 segment. The mean number of the CPN motoneurones in the rat and monkey was 458 and 1148, respectively. A bimodal size distribution of motoneurones was found in both species.

Matched MeSH terms: Peroneal Nerve/cytology*
Fulltext Performance analysis of noninvasive electrophysiological methods for the assessment of diabetic sensorimotor polyneuropathy in clinical research: a systematic review and meta-analysis with trial sequential analysis

Haque F, Reaz MBI, Ali SHM, Arsad N, Chowdhury MEH

Sci Rep, 2020 12 10;10(1):21770.
PMID: 33303857 DOI: 10.1038/s41598-020-78787-0

Despite the availability of various clinical trials that used different diagnostic methods to identify diabetic sensorimotor polyneuropathy (DSPN), no reliable studies that prove the associations among diagnostic parameters from two different methods are available. Statistically significant diagnostic parameters from various methods can help determine if two different methods can be incorporated together for diagnosing DSPN. In this study, a systematic review, meta-analysis, and trial sequential analysis (TSA) were performed to determine the associations among the different parameters from the most commonly used electrophysiological screening methods in clinical research for DSPN, namely, nerve conduction study (NCS), corneal confocal microscopy (CCM), and electromyography (EMG), for different experimental groups. Electronic databases (e.g., Web of Science, PubMed, and Google Scholar) were searched systematically for articles reporting different screening tools for diabetic peripheral neuropathy. A total of 22 studies involving 2394 participants (801 patients with DSPN, 702 controls, and 891 non-DSPN patients) were reviewed systematically. Meta-analysis was performed to determine statistical significance of difference among four NCS parameters, i.e., peroneal motor nerve conduction velocity, peroneal motor nerve amplitude, sural sensory nerve conduction velocity, and sural sensory nerve amplitude (all p

Matched MeSH terms: Peroneal Nerve/physiopathology
Fulltext The effects of short-term, rapid glycemic control on the peroneal nerve function and serum VCAM-1 and AGE in type 2 diabetic patients in Malaysia

Norlinah MI, Hamizah R, Md Isa SH, Wan Nazaimoon WM, Khalid BA

Indian J Med Sci, 2009 Apr;63(4):131-8.
PMID: 19414982

BACKGROUND: The role of endothelial injury and circulating adhesion molecule in the development and progression of diabetic peripheral neuropathy in the long-term has been established previously.
AIMS: To study the effects of short-term glycemic control using insulin and oral hypoglycemic agent therapy (OHA) on the peroneal nerve function and vascular cell adhesion molecule-1 (VCAM-1) and advanced glycation endproducts (AGE) levels in type 2 diabetic patients.
SETTINGS AND DESIGN: A randomized controlled study involving poorly controlled (HbA1c, 7.5%-11%) type 2 diabetic patients attending the endocrinology outpatient center in a tertiary hospital in Kuala Lumpur.
MATERIALS AND METHODS: Twenty-nine patients were randomized to receive insulin (n=15) or OHA (n=14) for 8 weeks. The glycemic variables (HbA1c, fasting plasma glucose [FPG], fructosamine), VCAM-1, serum AGE and the peroneal motor conduction velocity (PMCV) were measured at baseline and at 4-week intervals.
STATISTICAL ANALYSIS USED: Paired 't' test or Kruskal Wallis test; and the unpaired 't' test or Mann-Whitney U test were used for within-group and between-group analyses, respectively. Correlation was analyzed using Spearman's correlation coefficient.
RESULTS: Within-group analysis showed significant progressive improvement in HbA1c at weeks 4 and 8 in the insulin group. The PMCV improved significantly in both groups by week 8, and by week 4 (P = 0.01) in the insulin group. PMCV correlated negatively with VCAM-1 (P = 0.031) and AGE (P = 0.009) at week 8.
CONCLUSION: Aggressive glycemic control with insulin improves the peroneal nerve function within 4 weeks. Improvement in the serum VCAM-1 and AGE levels correlated significantly with improvement in peroneal nerve conduction velocity only in the insulin group.
Study site: Tertiary endocrinology outpatient center in Kuala Lumpur, Malaysia

Matched MeSH terms: Peroneal Nerve/drug effects; Peroneal Nerve/physiopathology
Fulltext Adoption of the mobile health screening programme for farming communities: a study among pesticide-exposed farmers from north east of Peninsular Malaysia

Zariyantey Abdul Hamid, Zaliha Harun, Syarif Husin Lubis, Nihayah Mohamed, Ismarulyusda Ishak, Hidayatul Fathi Othman, et al.

Jurnal Sains Kesihatan Malaysia, 2014;12(2):63-70.
MyJurnal

Health awareness promotion among farming communities are important for a sustainable agriculture activities. A cross-sectional study was conducted to assess health status among farming communities in Cameron Highlands, Pahang (n = 61) and Bachok and Pasir Puteh, Kelantan (n = 143). Mobile Health Screening Programme composed of assessment of blood glucose, blood cholesterol, haemoglobin, blood pressure, pterygium, lung function and nerve conductive velocity was utilized. Our results indicate that the percentage of Cameron Highland’s farmers with hyperglycaemia, systolic hypertension, diastolic hypertension and anaemia were 8.2%, 14.8%, 11.5% and 8.2%, respectively. However, higher percentage of farmers in Bachok and Pasir Puteh, Kelantan with hyperglycaemia (32.8%), hypercholesterolaemia (83%), anaemia (24.2%) and systolic hypertension (41.9%) were observed. Pterygium was positive for 88.6% of farmers in Cameron Highlands and 94.4% in Bachok and Pasir Puteh. Lung function test shows that 61.7% and 11.4% of farmers in Cameron Highlands had restrictive and obstructive lung, respectively. In Bachok and Pasir Puteh, a total of 19.8%, 55.5% and 23.9% of farmers were found to have obstructive, restrictive and combined obstructive and restrictive lung, respectively. Current Perception Threshold (CPT) value which indicate nerve conductive velocity were significantly increased (p < 0.05) among Cameron Highland’s farmers for both median and peroneal nerve at all frequencies (5 Hz, 250 Hz and 2000 Hz). In Bachok and Pasir Puteh, the values of the CPT for median nerve was significantly increased (p < 0.05) for all frequencies (5, 250 and 2000 Hz). Meanwhile, a signifi cant increased (p < 0.05) was observed for the CPT values for peroneal nerve at the frequencies of 250 and 2000 Hz as compared to control groups. In conclusion, analysis revealed different health problem among the studied farming communities which could be influenced by the differences in farming practices. Thus, employed Mobile Health Screening Programme offers a monitoring approach that could highlight the need for suitable health services and awareness programmes for different farming communities.

Matched MeSH terms: Peroneal Nerve
Hericium erinaceus (Bull.: Fr.) Pers., a medicinal mushroom, activates peripheral nerve regeneration

Wong KH, Kanagasabapathy G, Naidu M, David P, Sabaratnam V

Chin J Integr Med, 2016 Oct;22(10):759-67.
PMID: 25159861 DOI: 10.1007/s11655-014-1624-2

OBJECTIVE: To study the ability of aqueous extract of Hericium erinaceus mushroom in the treatment of nerve injury following peroneal nerve crush in Sprague-Dawley rats.
METHODS: Aqueous extract of Hericium erinaceus was given by daily oral administration following peroneal nerve crush injury in Sprague-Dawley rats. The expression of protein kinase B (Akt) and mitogen-activated protein kinase (MAPK) signaling pathways; and c-Jun and c-Fos genes were studied in dorsal root ganglia (DRG) whereas the activity of protein synthesis was assessed in peroneal nerves by immunohistochemical method.
RESULTS: Peripheral nerve injury leads to changes at the axonal site of injury and remotely located DRG containing cell bodies of sensory afferent neurons. Immunofluorescence studies showed that DRG neurons ipsilateral to the crush injury in rats of treated groups expressed higher immunoreactivities for Akt, MAPK, c-Jun and c-Fos as compared with negative control group (P <0.05). The intensity of nuclear ribonucleoprotein in the distal segments of crushed nerves of treated groups was significantly higher than in the negative control group (P <0.05).
CONCLUSION: H. erinaceus is capable of promoting peripheral nerve regeneration after injury. Potential signaling pathways include Akt, MAPK, c-Jun, and c-Fos, and protein synthesis have been shown to be involved in its action.

Matched MeSH terms: Peroneal Nerve/physiology
Fulltext Peripheral Nerve Regeneration Following Crush Injury to Rat Peroneal Nerve by Aqueous Extract of Medicinal Mushroom Hericium erinaceus (Bull.: Fr) Pers. (Aphyllophoromycetideae)

Wong KH, Naidu M, David P, Abdulla MA, Abdullah N, Kuppusamy UR, et al.

Evid Based Complement Alternat Med, 2011;2011:580752.
PMID: 21941586 DOI: 10.1093/ecam/neq062

Nerve crush injury is a well-established axonotmetic model in experimental regeneration studies to investigate the impact of various pharmacological treatments. Hericium erinaceus is a temperate mushroom but is now being cultivated in tropical Malaysia. In this study, we investigated the activity of aqueous extract of H. erinaceus fresh fruiting bodies in promoting functional recovery following an axonotmetic peroneal nerve injury in adult female Sprague-Dawley rats by daily oral administration. The aim was to investigate the possible use of this mushroom in the treatment of injured nerve. Functional recovery was assessed in behavioral experiment by walking track analysis. Peroneal functional index (PFI) was determined before surgery and after surgery as rats showed signs of recovery. Histological examinations were performed on peroneal nerve by immunofluorescence staining and neuromuscular junction by combined silver-cholinesterase stain. Analysis of PFI indicated that return of hind limb function occurred earlier in rats of aqueous extract or mecobalamin (positive control) group compared to negative control group. Regeneration of axons and reinnervation of motor endplates in extensor digitorum longus muscle in rats of aqueous extract or mecobalamin group developed better than in negative control group. These data suggest that daily oral administration of aqueous extract of H. erinaceus fresh fruiting bodies could promote the regeneration of injured rat peroneal nerve in the early stage of recovery.

Matched MeSH terms: Peroneal Nerve