Which physical findings are characteristic of peroneal mononeuropathy?

Updated: Jun 08, 2018
  • Author: Shaheen E Lakhan, MD, PhD, MS, MEd; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

See the list below:

  • If the lesion is severe, a complete foot drop that spares plantar flexion and foot inversion is noted (compared with L5 radiculopathy, lumbosacral plexopathy, or sciatic neuropathy).

  • The gait will be high-stepping with "foot slapping."

  • In milder cases, weakness of foot eversion and dorsiflexion may be noted only by asking the patient to walk on his or her heels.

  • Tapping of the nerve at the fibular head may produce pain and tingling in the peroneal sensory nerve distribution.

  • Distribution of peroneal sensory disturbance assists in localizing the lesion. Numbness in the lower part of the lateral distal leg suggests superficial peroneal sensory involvement, while numbness of the upper part of the lateral distal leg suggests deep peroneal sensory distribution (see following image). With common peroneal lesions, sensory loss is noted over the lateral calf and dorsum of the foot but spares the fifth toe.

    Peroneal sensory distribution: The striped area is Peroneal sensory distribution: The striped area is the superficial peroneal sensory distribution. The green solid area represents the deep peroneal sensory distribution. All 3 areas shaded would be numb in a patient with a common peroneal nerve lesion.

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