11.03.2017 Views

DR Medhat MRCP

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

Mononeuropathy<br />

• Def : Neuropathy (inflammatory or degenerative process) affecting 1 nerve trunk in 1 limb<br />

• Common mononeuropathies:<br />

Lower limb nerves :<br />

Sciatic nerve (L4,5 & S1,2,3) :<br />

o Origin : from lumbosacral plexus (L4,5 & S1,2,3).<br />

o Course : emerges from pelvis below piriformis & enters thigh between ischial<br />

tuberosity & greater trochanter descends in back of thigh.<br />

o Termination : in the popliteal fossa by giving 2 terminal branches (common peroneal<br />

& tibial).<br />

o Lesion (sciatica) :<br />

- Most commonly from misplaced gluteal injections.<br />

- Features ( = common peroneal + tibial nerve palsy).<br />

Sensory loss over the lateral border of the lower leg & entire foot except<br />

the medial malleolus which is supplied by saphenous nerve.<br />

Weakness of all muscles below the knee (foot drop) as well as knee flexors<br />

(inability to flex the knee).<br />

Loss of ankle jerk (normal knee jerk) & planter response .<br />

112

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!