title: Multiple locations of nerve compression: an unusual cause of persistent lower limb paresthesia.
abstract: A paucity of appreciation exists that the "double crush" phenomenon can account for persistent leg symptoms even after spinal neural decompression surgery. We present an unusual case of multiple locations of nerve compression causing persistent lower limb paresthesia in a 40-year old male patient. The patient's lower limb paresthesia was persistent after an initial spinal surgery to treat spinal lateral recess stenosis thought to be responsible for the symptoms. It was later discovered that he had peroneal muscle herniations that had caused superficial peroneal nerve entrapments at 2 separate locations. The patient obtained much symptomatic relief after decompression of the peripheral nerve. The "double crush" phenomenon and multiple levels of nerve compression should be considered when evaluating lower limb neurogenic symptoms, especially after spinal nerve root surgery.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. Electronic address: med80199@yahoo.com.
authors.forename: Chia-Liang
authors.initials: CL
authors.lastname: Ang
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Leon Siang Shen
authors.initials: LS
authors.lastname: Foo
mesh_terms: D000328:Adult; D019299:Decompression, Surgical; D006547:Hernia / Q000150:complications; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000601:surgery*; D035002:Lower Extremity / Q000294:innervation; D008297:Male; D009135:Muscular Diseases / Q000150:complications / Q000601:surgery*; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery*; D010292:Paresthesia / Q000209:etiology* / Q000601:surgery; D020427:Peroneal Neuropathies / Q000209:etiology / Q000601:surgery*; D013130:Spinal Stenosis / Q000209:etiology / Q000601:surgery*
keywords: nerve compression syndrome; nerve root; paresthesia; peripheral nerve injury; peroneal neuropathy