Clinical and neurophysiological study of peroneal nerve mononeuropathy after substantial weight loss in patients suffering from major depressive and schizophrenic disorder: Suggestions on patients' management.
BACKGROUND
Peroneal nerve is susceptible to injuries due to its anatomical course. Excessive weight loss, which reduces the fatty cushion protecting the nerve, is considered a common underlying cause of peroneal palsy. Other predisposing factors, such as prolonged postures, traumas of the region or concomitant pathologies (for example diabetes mellitus) contribute to the nerve damage. This study aims to reveal the multiple predisposing factors of peroneal nerve mononeuropathy after substantial weight loss that coexist in psychiatric patients and to make suggestions on their management.


METHODS
Nine psychiatric inpatients, major depressive or schizophrenic, with foot drop underwent a complete clinical neurological and neurophysiological examination. All had excessive weight loss, which was completed in a short period of time and had not resulted from a well-balanced low-calorie diet, but was due to their psychiatric illness. Data regarding predisposing factors to peroneal nerve mononeuropathy were gathered, such as habitual leg crossing, squatting or other prolonged postures.


RESULTS
The clinical examination and the neurophysiological evaluation in all patients were indicative of a focal lesion of the peroneal nerve at the fibular head.


CONCLUSIONS
Patients with major depressive and schizophrenic disorders gather multiple predisposing factors to peroneal palsy, adequate to classify them at a high risk group. The better focus of the attendant medical and nursing staff on this condition, the early clinical and neurophysiologic evaluation and surgical interventions may enable an improved management and prognosis of these patients.
Papagianni
Aikaterini
A
Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece.
Oulis
Panagiotis
P
Department of Psychiatry, Aeginition Hospital, Medical School, University of Athens, Greece.
Zambelis
Thomas
T
Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece.
Kokotis
Panagiotis
P
Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece.
Koulouris
George C
GC
Department of Psychiatry, Aeginition Hospital, Medical School, University of Athens, Greece.
Karandreas
Nikos
N
Laboratory of Electromyography and Clinical Neurophysiology, Department of Neurology, Aeginition Hospital, Medical School, University of Athens, Greece.