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Atlas of Neuromuscular Diseases - part 6

Các dây thần kinh sural được hình thành từ hai chi nhánh: các dây thần kinh trung gian của da bê (dây thần kinh xương chày) và các dây thần kinh bên của da bê (thông thường mác thần kinh). Nói chung, các dây thần kinh sural chỉ chứa sợi cảm giác. | 237 Sural nerve Genetic testing NCV EMG Laboratory Imaging Biopsy used The sural nerve is formed from two branches the medial cutaneous nerve of the Anatomy calf tibial nerve and the lateral cutaneous nerve of the calf common peroneal nerve . In general the sural nerve contains only sensory fibers. It runs along the middle of the calf region lateral to the Achilles tendon and lateral malleolus. The nerve innervates the lateral ankle and lateral aspect of the sole to the base of the 5th toe. The sural nerve gives rise to the lateral calcaneal nerves posterior and proximal to the tip of the lateral malleolus. At the proximal fifth metatarsal tuberosity the nerve divides into a lateral branch the dorsolateral cutaneous nerve of the fifth toe and a medial branch providing sensation to the dorsome-dial fifth toe and dorsolateral fourth toe. Numbness pain and paresthesias at the lateral side of the foot. Symptoms Symptoms after excision Dysesthesias occur in 40-50 of cases. Neuroma formation may also occur. Postoperative scarring may result in dysesthesias. There is no difference in outcome between whole nerve biopsy or fascicular biopsy. Tinel s sign may indicate the site of the lesion. Baker s Cyst Arthroscopy operation for varicose veins Calf muscle biopsies Elastic socks Footwear Tight lacing Acute or chronic ankle sprain Avulsion fracture of base of 5th metatarsal bone Adhesion after soft tissue injury Fractured sesamoid bone in peroneus longus tendon Ganglion Idiopathic neuroma Osteochondroma Sitting with crossed ankles Shoes Signs Pathogenesis Popliteal fossa Calf Ankle 238 Surgery Ankle fractures talus calcaneus base of fifth metatarsal Achilles tendon rupture Diagnosis Laboratory include genetics electrophysiology imaging biopsy sensory NCV Diagnosis of neuroma Tinel s sign pain and paresthesias below distal fibula or along the lateral or dorsolateral border of the foot. Differential diagnosis Asymmetric neuropathy Herpes zoster rare S1 irritation Therapy .