Article

Two patients with recalcitrant unilateral heel pain and plantar fasciitis were
referred for electrodiagnostic evaluation. They both reported constant, sharp,
unilateral medial heel pain, with nocturnal symptoms, as well as exacerbation by
weight-bearing activities. Examination of both patients demonstrated focal medial
heel tenderness and a Tinel sign over the tarsal tunnel on the affected side.
Neither patient had weakness or sensory deficits in the affected foot. In both
patients, findings on nerve conduction studies were normal in the affected foot,
including the first branch of the lateral plantar nerve (FBLPN),
as well as the
medial and lateral plantar motor and sensory (ie, mixed nerve) responses. Needle
electromyographic (EMG) abnormalities were found only in the abductor digiti
quinti pedis (ADQP), an intrinsic foot muscle that is exclusively innervated by
the FBLPN, but there were no EMG abnormalities noted in the medial or lateral
plantar-innervated muscles studied, nor the contralateral ADQP. Both patients
then underwent surgical decompression of the FBLPN. Postoperative follow-up
(patient 1 at 10 months, patient 2 at 21 months) revealed excellent outcomes, as
defined by symptom resolution, in both patients. Electrodiagnostic evaluation was
useful in diagnosing isolated first branch lateral plantar neuropathy.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
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Langue : ANGLAIS