Differential diagnosis and recovery of acute bilateral foot drop in a patient with a history of low back pain: A case report

Physiotherapy Theory and Practice
Melanie Lomaglio, Bob Canale

Abstract

Acute bilateral foot drop is rare and may be due to peripheral or central lesions. The purpose of this case report was to describe the differential diagnosis and recovery of a patient with low back pain (LBP) that awoke with bilateral foot drop. A 39-year-old man with a history of LBP awoke with a steppage gait pattern. Spinal imaging and tapping were negative for sinister pathologies. A subsequent history taken by the physical therapist uncovered that the patient had previously taken a narcotic and slept in a kneeling position to relieve his LBP. Strength and sensory testing revealed isolated impairments in the fibular nerve distribution, and bilateral fibular palsy was suspected and later confirmed with electrophysiological studies. Surgical fibular nerve decompression was performed, and the patient underwent physical therapy. Five months later the patient demonstrated antigravity strength and a partial return of sensation. By 17 months, his Lower Extremity Functional Scale had improved from 17/80 to 78/80, revealing a near complete recovery. The patient's history of LBP was a "red herring" that delayed the diagnosis and caused undue stress to the patient. This case stresses the importance of a thorough history and clinical e...Continue Reading

References

May 1, 1980·Archives of Neurology·R L Koller, N K Blank
Mar 20, 2004·The Journal of Orthopaedic and Sports Physical Therapy·Laura C SchmittKatherine S Rudolph
Mar 8, 2007·Chiropractic & Osteopathy·Scott C Cuthbert, George J Goodheart
May 27, 2008·Practical Neurology·John D Stewart
Sep 23, 2008·Multiple Sclerosis : Clinical and Laboratory Research·D H MillerC H Polman
May 14, 2009·Neurosurgical Focus·Sarah Walsh, Rajiv Midha
May 27, 2009·Current Reviews in Musculoskeletal Medicine·Jennifer Baima, Lisa Krivickas
Feb 3, 2012·ANZ Journal of Surgery·Mahesh Ramanan, K Nadana Chandran
Mar 28, 2013·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·G BstehW N Löscher
Apr 26, 2013·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Leila Kyavar, Josef G Heckmann
May 7, 2013·Neurologic Clinics·Mazen M Dimachkie, Richard J Barohn
May 15, 2015·Asian Journal of Neurosurgery·H KertmenZ Sekerci
Jun 7, 2015·Journal of Neuroengineering and Rehabilitation·Karin PieberOthmar Schuhfried
Dec 25, 2015·The Journal of the American Academy of Orthopaedic Surgeons·Chad PoageBrandon Scott

❮ Previous
Next ❯

Citations

Feb 8, 2021·Acta neurochirurgica·Andreas K DemetriadesRichard Gullan

❮ Previous
Next ❯

Related Concepts

Related Feeds

Auditory Perception

Auditory perception is the ability to receive and interpret information attained by the ears. Here is the latest research on factors and underlying mechanisms that influence auditory perception.

Related Papers

The Canadian Journal of Plastic Surgery = Journal Canadien De Chirurgie Plastique
Rebecca J Greer-BayramogluBing Siang Gan
Pakistan Journal of Medical Sciences
Murat ZumrutAhmet Kucukapan
The Journal of Orthopaedic and Sports Physical Therapy
Michael Ryder, Gail D Deyle
Transactions of the Royal Society of Tropical Medicine and Hygiene
Alexandre Leite de SouzaAntonio Carlos Seguro
© 2022 Meta ULC. All rights reserved