Squatting-induced bilateral peroneal nerve palsy in a sewer pipe worker.
Compression neuropathy of the common peroneal nerve (CPN) at the fibula head is a common condition, but it has not attracted attention in working environments. Here, we report a 38-year-old sewer pipe worker who presented with bilateral CPN palsy following 6h working with a squatting posture in a narrow sewer pipe. During the work, he could not stretch his legs sufficiently because of the confined space. His symptoms deteriorated with repetition of the same work for 1 week. Motor nerve conduction study showed conduction block at the fibula head of bilateral CPNs, compatible with compression neuropathy at this lesion. Three months after cessation of work requiring the causative posture, his symptoms and neurophysiological abnormalities had resolved completely. Almost all seven of his co-workers presented transiently with similar and milder symptoms, although one showed CPN palsy for 6 months. Prolonged squatting posture in a confined space causes acute compression neuropathy at the fibula head in the CPN. More attention should be paid to 'confined space worker's compression neuropathy'.
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. mkodaira@shinshu-u.ac.jp.
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Kodaira
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Sekijima
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Ohashi
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Takahashi
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Ueno
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Miyazaki
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Ikeda
D000328:Adult; D001176:Arthrogryposis / Q000150:complications* / Q000175:diagnosis; D015417:Hereditary Sensory and Motor Neuropathy / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D010543:Peroneal Nerve / Q000503:physiopathology*; D020427:Peroneal Neuropathies / Q000150:complications / Q000175:diagnosis; D011187:Posture / Q000502:physiology*; D020429:Tibial Neuropathy / Q000150:complications / Q000175:diagnosis
Compression neuropathy; confined space; peroneal nerve palsy; squatting; worker.