Letter to the Editor
Sporadic neuropathy of the peroneal nerve in the knee during the alarm state due to SARS-CoV-2 pandemic
Neuropatía esporádica de nervio peroneal en la rodilla durante el estado de alarma por pandemia SARS-CoV-2
a Servicio de Neurofisiología Clínica, Hospital General Universitario de Castellón, Castellón de la Plana, Spain
b Servicio de Neurología, Hospital General Universitario de Castellón, Castellón de la Plana, Spain
c Servicio de Traumatología, Hospital General Universitario de Castellón, Castellón de la Plana, Spain
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"apellidos" => "Parra" "email" => array:1 [ 0 => "parra_sil@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Badenes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "Grande" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "L." "apellidos" => "Barea-Moya" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "J.M." "apellidos" => "Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neurofisiología Clínica, Hospital General Universitario de Castellón, Castellón de la Plana, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neurología, Hospital General Universitario de Castellón, Castellón de la Plana, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Traumatología, Hospital General Universitario de Castellón, Castellón de la Plana, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neuropatía esporádica de nervio peroneal en la rodilla durante el estado de alarma por pandemia SARS-CoV-2" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We are currently facing an exceptional SARS-CoV-2 pandemic situation that required the confinement of the general population for weeks, with changes in daily habits, a decrease in habitual physical activity and a sedentary lifestyle. Involvement of the external popliteal sciatic nerve (EPSN) or peroneal nerve at the knee is the most common compressive mononeuropathy of the lower extremities<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1–4</span></a>. Its aetiology is related to numerous external factors or systemic diseases 1–3, although its sporadic occurrence is less frequent. We present the cases of sporadic peroneal nerve neuropathy seen at the Clinical Neurophysiology Service of the Hospital General de Castellón that occurred during the state of alarm period (from 14th March to 21st June 2020).</p><p id="par0010" class="elsevierStylePara elsevierViewall">Of the patients referred to our service for electromyography (EMG) during 2020, 11 presented with clinical signs of peroneal nerve involvement in the knee without a clear trigger. Seven of them started to develop symptoms during the 14 weeks that the state of alarm remained in force in Spain. One of them showed on MRI a cystic image suggestive of a ganglion that displaced and compressed the EPSN, and was therefore excluded from the study. We therefore analysed 6 cases, 4 men and 2 women, with a mean age of 28.5 years (range 20–49), with no medical history of interest. None of them had suffered recent weight loss or COVID infection. Three of them reported having been sitting with maintained postures (two with legs crossed and one with legs stretched out on a table) for several hours at a time. Clinical examination at the time of the EMG study (one month after onset) showed weakness in dorsiflexion and eversion of the foot of varying severity at that time (from 0 to 4/5 according to the Medical Research Council), with normal foot inversion and ROTs present in 5 of the patients. Three patients reported clear hypoaesthesia in the dorsal region of the foot. One patient had hardly any symptoms as he delayed consultation for 2 months for fear of contagion.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the EMG study all patients showed focal slowing and moderate-severe peroneal nerve motor conduction block at the knee. Distal peroneal nerve motor amplitudes were found to be mildly-moderately decreased. The distal sensory conductions of the superficial peroneal nerve were altered in 5 patients, with the rest of the sensory and motor nerves explored in the lower limbs being normal. Active denervation was observed in muscles dependent on the common trunk of the peroneal nerve in 5 patients and only in muscles of the deep branch in one, with normality in other muscles dependent on L5. The evolution in all of them was favourable, 3 months later 4 patients presented complete recovery of symptoms and 2 patients showed clear improvement.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Peroneal nerve neuropathy at the knee is the third most common compressive neuropathy after median nerve neuropathy and ulnar neuropathies.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It is normally related to numerous external factors (traumas, compressions, tumours, iatrogenesis) and systemic factors (diabetes mellitus, inflammatory diseases, etc.), etc.).<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2–4</span></a> Less frequently, sporadic involvement of this nerve can be observed in the knee, usually after prolonged or inadequate posture, especially if there has been significant weight loss.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1–5</span></a> We have not found recent incidence data in the published literature. In our department in 2020, we observed a 50% increase over the previous 3 years. The 6 cases included in our study were mostly young males, with no medical history of interest, and the clinical suspicion was well oriented from the beginning. The EMG study confirmed the suspicion in all of them, ruling out a predisposing polyneuropathy and other possible differential diagnoses, with data compatible with moderate–severe neuroapraxia and mild-moderate secondary axonal degeneration. Three patients reported sustained postures, with a higher than usual number of hours of sitting during confinement.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The worldwide SARS-CoV-2 pandemic has led to a global health crisis with hospital overcrowding, but also loss of employment, inability to perform usual activities, and probably increased sedentary lifestyles for weeks, facilitating compression of this nerve in the knee. We believe it is important to stress the need to maintain proper posture, avoiding crossing the legs or resting the knees on hard surfaces for prolonged periods of time, to avoid compression of the peroneal nerve. The EMG study is useful to confirm the diagnosis, exclude other possible causes, typify the injury and give an early prognosis.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Level of evidence</span><p id="par0030" class="elsevierStylePara elsevierViewall">Level of evidence <span class="elsevierStyleSmallCaps">v</span>.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0035" class="elsevierStylePara elsevierViewall">This research did not receive any specific funding from public sector agencies, the commercial sector or not-for-profit entities.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interests</span><p id="par0040" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Level of evidence" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interests" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neuropatía compresiva del nervio peroneo" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.F. Espinosa de los Monteros Kelley" 1 => "J.F. Clifton Correa" 2 => "L. López Almejo" 3 => "E. Navarro Becerra" 4 => "J.A. Villarruel Sahagún" 5 => "J.J. Zermeño Rivera" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Orthotips" "fecha" => "2014" "volumen" => "10" "paginaInicial" => "93" "paginaFinal" => "99" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibular (peroneal) neuropathy: electrodiagnostic features and clinical correlates" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Marciniak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pmr.2012.08.016" "Revista" => array:6 [ "tituloSerie" => "Phys Med Rehabil Clin N Am" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "121" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23177035" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peroneal nerve palsy: evaluation and management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Poage" 1 => "C. Roth" 2 => "B. Scott" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5435/JAAOS-D-14-00420" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Orthop Surg" "fecha" => "2016" "volumen" => "24" "paginaInicial" => "1" "paginaFinal" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26700629" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multicenter study of peroneal mononeuropathy: clinical, neurophysiologic, and quality of life assessment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Aprile" 1 => "P. Caliandro" 2 => "G. La Torre" 3 => "P. Tonali" 4 => "M. Foschini" 5 => "M. Mondelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1085-9489.2005.10304.x" "Revista" => array:6 [ "tituloSerie" => "J Peripher Nerv Syst" "fecha" => "2005" "volumen" => "10" "paginaInicial" => "259" "paginaFinal" => "268" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16221285" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical characteristics of peroneal nerve palsy by posture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.K. Yu" 1 => "J.S. Yang" 2 => "S.H. Kang" 3 => "Y.J. Cho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3340/jkns.2013.53.5.269" "Revista" => array:6 [ "tituloSerie" => "J Korean Neurosurg Soc" "fecha" => "2013" "volumen" => "53" "paginaInicial" => "269" "paginaFinal" => "273" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23908699" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/18884415/0000006600000005/v5_202404150626/S1888441522001953/v5_202404150626/en/main.assets" "Apartado" => array:4 [ "identificador" => "92787" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales / Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/18884415/0000006600000005/v5_202404150626/S1888441522001953/v5_202404150626/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441522001953?idApp=UINPBA00004N" ]
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