scholarly journals Neuropathy Case Seen After Bariatric Surgery

2021 ◽  
Vol 5 (2) ◽  
pp. 01-04
Author(s):  
Hayriye Alp
Keyword(s):  
Bariatric Surgery ◽  
Peroneal Nerve ◽  
Rare Complication ◽  
Complete Recovery ◽  
Lumbar Region ◽  
Rapid Weight Loss ◽  
Fibular Head ◽  
Neural Therapy ◽  
Peroneal Neuropathy ◽  
Long Time

Peroneal neuropathy is a rare complication after bariatric surgery, but it occurs in 15% of mononeuropathy. The etiology of peroneal neuropathy is multifactorial and is often blamed for these factors due to rapid weight loss and nutritional imbalance. Emine Karaca, 25 years old, female Patient 1 year ago, she had a stomach reduction (obesity surgery) surgery due to her weight of 130 kg. Six months after the operation, it decreased to 60 kg. Meanwhile, numbness in his right foot began to be pain and loss of strength after the operation. In the EMG performed on May 10, 2016, he was diagnosed with Fibulahead entrapment neuropathy-low foot. He was tied to lie in the same position for a long time during the operation. After this diagnosis, 15% prolotherapy was applied around the peroneal nerve of the fibular head on 11.05.2016. Prolotherapy was applied 2 times with 10 days intervals. L4-5 and L5-S1 segmental neural therapy in the lumbar region and neural therapy around the fibular head of the peroneal nerve and along its trace were applied twice a week. After a total of 2 prolotherapy and 6 neuraltherapy applied in 3 weeks, complete clinical recovery was achieved. This complete recovery was confirmed by EMG. Since electrophysiological findings of denervation occur after 2-3 weeks, it is recommended that EMG examination be performed 3 weeks later. Treatment includes relief of complaints (analgesics and gabapentin), physical therapy applications and support immobilizers. In cases that do not respond to treatment, nerve exploration and relaxation is provided with a surgical approach. Prolotherapy and neural therapy, among complementary medicine modalities, can also be used in peroneal nerve neuropathy.

scholarly journals Peroneal Nerve Palsy due to Bulky Osteochondroma from the Fibular Head: A Rare Case and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
T. Cherrad ◽  
M. Bennani ◽  
H. Zejjari ◽  
J. Louaste ◽  
L. Amhajji
Keyword(s):  
Peroneal Nerve ◽  
Nerve Palsy ◽  
Common Peroneal Nerve ◽  
Complete Recovery ◽  
Foot Drop ◽  
Peroneal Nerve Palsy ◽  
Fibular Head ◽  
Success Rates ◽  
Proximal Fibula ◽  
Compressive Neuropathy

Common peroneal neuropathy is the most common compressive neuropathy in the lower extremities. The anatomical relationship of the fibular head with the peroneal nerve explains entrapment in this location. We report the case of a 14-year-old boy admitted with a left foot drop. The diagnosis was an osteochondroma of the proximal fibula compressing the common peroneal nerve. The patient underwent surgical decompression of the nerve and resection of the exostosis. Three months postoperatively, there was a complete recovery of the deficits. The association of osteochondroma and peroneal nerve palsy is rare. Early diagnosis is required in order to adjust the management and improve the results. It is worth to underscore that surgical resection is proven to be the appropriate treatment method ensuring high success rates.

scholarly journals Clinical manifestations, diagnosis, and surgical treatment of compressive common peroneal neuropathy at the level of the fibular head

2021 ◽  
Vol 13 (1) ◽  
pp. 18-23
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov
Keyword(s):  
Surgical Treatment ◽  
Peroneal Nerve ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Common Peroneal Nerve ◽  
Complete Recovery ◽  
Diagnosis And Treatment ◽  
Partial Recovery ◽  
Nerve Decompression ◽  
Peroneal Neuropathy

Common peroneal neuropathy (CPN) is the most common tunnel neuropathy in the lower extremities, many issues of diagnosis and treatment of which require further study.Objective: to analyze the clinical manifestations of CPN, methods of its diagnosis and treatment results.Patients and methods. Eighty patients (31 women and 49 men) aged 18 to 82 years (mean age, 51 years) with compressive CPN were followed up during 2012–2018. Unilateral CPN and bilateral CPN were found in 76 and 4 patients, respectively. Eighty-four common peroneal nerve decompression operations were performed.Results and discussion. There was paralytic CPN in 73 (87%) surgical cases, painful CPN in 8 (9.5%), and intermittent CPN in 3 (3.5%). Diagnostic errors (when CPN was regarded as discogenic radiculopathy or lumbar stenosis) were noted in the painful and intermittent forms of the disease. After surgical treatment, complete recovery of peroneal nerve function was observed in 61 (72.6%) of the 84 surgical cases; its partial recovery in 15 (17.9%). Positive results were seen in all cases of painful and intermittent CPN, whereas they were more often observed in paralytic CPN if the operation was performed early (up to 12 months) after the onset of the disease.Conclusion. Common peroneal nerve decompression is an effective and safe therapeutic method that, in painful and intermittent CPN, leads to complete reversal of symptoms and, in the paralytic form of the disease, it is most effective in the early stages of the disease.

scholarly journals A near-fatal case of intussusception and ischaemic perforation of stomach in first-trimester pregnancy: eight years after laparoscopic Roux-en-Y gastric bypass

2018 ◽  
Vol 11 (1) ◽  
pp. e226094 ◽  
Author(s):  
Rajarshi Bhadra ◽  
Meyappan Somasundaram ◽  
Michael M Nowak ◽  
Keyvan Ravakhah
Keyword(s):  
Bariatric Surgery ◽  
Rare Complication ◽  
Fatal Case ◽  
Complete Recovery ◽  
First Trimester ◽  
Obesity Epidemic ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
First Trimester Of Pregnancy ◽  
Increasing Demand

The increasing demand and popularity of bariatric surgery are not only due to the ever-increasing obesity epidemic but to tackle obesity-related comorbidities like diabetes and hypertension. However, bariatric surgery is not free of complications. One rare complication is intussusception, jejuno-jejunal intussusception being the most common. Intussusception has been defined both in pregnant and in non-pregnant women as well as men. We describe the case of a 40-year-old woman in the first trimester of pregnancy came to the hospital with worsening abdominal pain, was found to have intussusception of small bowel involving the jejunum, along with ischaemic perforation and necrosis of the fundus of the stomach. Postsurgery, the patient had a complete recovery and eventually, she successfully delivered an intact, viable fetus.

scholarly journals A Rare Complication After Bariatric Surgery: Peroneal Neuropathy

2018 ◽  
Vol 21 (2) ◽  
pp. 86-89
Author(s):  
Esin YILMAZ ◽  
Barın SELÇUK ◽  
Merve AKYÜZ ◽  
Ilgın SADE ◽  
Murat İNANIR
Keyword(s):  
Bariatric Surgery ◽  
Rare Complication ◽  
Peroneal Neuropathy

A Rare Complication of Bariatric Surgery: Retrograde Intussusception

2017 ◽  
Vol 27 (11) ◽  
pp. 2996-2998 ◽  
Author(s):  
Halis Bag ◽  
Serkan Karaisli ◽  
Salih Can Celik ◽  
Haldun Kar ◽  
Fatma Tatar
Keyword(s):  
Bariatric Surgery ◽  
Rare Complication ◽  
Retrograde Intussusception

scholarly journals Dynamic neuropathy of the common peroneal nerve at the level of the fibular head (literature review and case report)

2019 ◽  
Vol 21 (1) ◽  
pp. 54-59
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov ◽  
N. B. Vuitsyk ◽  
F. V. Grebenev
Keyword(s):  
Ankle Joint ◽  
Peroneal Nerve ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Common Peroneal Nerve ◽  
Diagnostic Methods ◽  
Fibular Head ◽  
Study Objective ◽  
The Common ◽  
The Right

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.

scholarly journals Study of clinical and demographic profile of patients diagnosed with secretory otitis media

2017 ◽  
Vol 3 (3) ◽  
pp. 715
Author(s):  
Ajeet Kumar Khilnani ◽  
Viral Prajapati
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Complete Recovery ◽  
Treatment Modalities ◽  
Common Symptom ◽  
Secretory Otitis Media ◽  
Long Time ◽  
Bilateral Deafness

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Secretory Otitis Media (SOM) is a common otological condition in children presenting most commonly with hearing loss. If untreated for long time, it can affect the language development of child. Its causes are multifactorial and treatment depends on the etiology. Various treatment modalities (medical and surgical) are available and they are administered in isolation or in combination. The objectives of the study were the present study was conducted with the objectives of knowing the most common age group affected by SOM, the common etiological factors of SOM and the outcome of various modalities of treatment of SOM.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>This prospective study was conducted at a tertiary care teaching hospital of North Gujarat. IEC approval and consent from the patients were taken. 40 patients diagnosed with SOM were included in the study and their clinical and demographic details and treatment outcomes were studied.  </p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>Of the 40 patients, 65% were males. SOM was common in young children. Most of the cases (55%) were below 10 years of age. In 80% of cases SOM was bilateral. Deafness was the most common symptom (95%) with which patients presented with, followed by URTI and pain. All patients had impaired tympanic membrane mobility. Retraction of tympanic membrane was the next common otoscopic finding (85%). Initial management was medical and 18 patients required surgical intervention.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>SOM is a common ear disorder in children. Initial medical treatment has a definitive role and should be tried in all cases before surgical intervention is contemplated. A variety of surgical procedures are available which can be used depending on the indication. Complete recovery is expected to occur in most of the cases by a period of 3-6 months.</p>

scholarly journals Varied Presentation and Importance of MR Neurography of the Common Fibular Nerve in Slimmer’s Paralysis

2021 ◽  
pp. 555-564
Author(s):  
Lisa B.E. Shields ◽  
Vasudeva G. Iyer ◽  
Christopher B. Shields ◽  
Yi Ping Zhang ◽  
Abigail J. Rao
Keyword(s):  
Weight Loss ◽  
Nerve Palsy ◽  
Rapid Weight Loss ◽  
Fibular Head ◽  
Fat Pad ◽  
Mr Neurography ◽  
Short Period ◽  
The Common ◽  
Fibular Nerve ◽  
Common Fibular Nerve

Slimmer’s paralysis refers to a common fibular nerve palsy caused by significant and rapid weight loss. This condition usually results from entrapment of the common fibular nerve due to loss of the fat pad surrounding the fibular head. Several etiologies of common fibular nerve palsy have been proposed, including trauma, surgical complications, improperly fitted casts or braces, tumors and cysts, metabolic syndromes, and positional factors. We present 5 cases of slimmer’s paralysis in patients who had lost 32–57 kg in approximately 1 year. In 2 cases, MR neurogram of the knee demonstrated abnormalities of the common fibular nerve at the fibular head. Two patients underwent a common fibular nerve decompression at the fibular head and attained improved gait and sensorimotor function. Weight loss, diabetes mellitus, and immobilization may have contributed to slimmer’s paralysis in 1 case. Awareness of slimmer’s paralysis in patients who have lost a significant amount of weight in a short period of time is imperative to detect and treat a fibular nerve neuropathy that may ensue.

scholarly journals SUCCESSFUL TREATMENT OF TRAUMATIC ORBITAL APEX SYNDROME WITH LOW DOSE STEROIDS - A CASE REPORT

2020 ◽  
pp. 214-215
Author(s):  
Tharini Senthamizh ◽  
Subashini Kaliaperumal
Keyword(s):  
Visual Loss ◽  
Low Dose ◽  
Rare Complication ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Dramatic Improvement ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Surgical Evacuation ◽  
Displaced Fracture

Traumatic Orbital Apex Syndrome is a rare complication of trauma presenting with visual loss, ophthalmoplegia, and anesthesia of cornea, forehead and maxillary regions. It requires immediate action as it poses great threat to permanent visual loss. The incidence of Traumatic orbital apex syndrome is very less compared to Superior Orbital fissure syndrome and traumatic optic neuropathy alone and only few cases have been reported till now. Management depends on the cause, those with displaced fracture fragments are treated by surgical decompression whereas those with edema or hematoma causing compression can be treated with steroids or surgical evacuation of hematoma. Previous reports have proved the usefulness of mega dose steroids in such cases. We report a case of Traumatic Orbital Apex Syndrome who presented with painful proptosis, visual loss, ophthalmoplegia and loss of sensation in periorbital region. Imaging confirmed hematoma causing compression of neurovascular structures and hence a trial of low dose corticosteroids was started. Our patient showed dramatic improvement in signs and symptoms with complete recovery in three weeks. Low dose steroids can be considered as an alternative to mega dose steroids to treat patients with indirect traumatic Orbital Apex Syndrome, thereby reducing the necessity of surgical evacuation in such cases.

scholarly journals Neglected intrauterine fetal demise for more than two decades leading to the development of a lithopedion: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Fitsum Fikru Gebresenbet ◽  
Abdu Mengesha Mulat ◽  
Namus Muhajir Nur ◽  
Ferehiwot Bekele Getaneh
Keyword(s):  
Vesicovaginal Fistula ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Clinical History ◽  
The Body ◽  
Obstructed Labor ◽  
Fetal Demise ◽  
Case Presentation ◽  
Intrauterine Fetal Demise ◽  
Long Time

Abstract Background Lithopedion is a word derived from the Greek words lithos, meaning stone, and paidion, meaning child, to describe a fetus that has become stony or petrified. Lithopedion is a rare complication of pregnancy which occurs when a fetus dies and becomes too large to be reabsorbed by the body. This entity in rare circumstances can be challenging for physicians to diagnose since it has a range of clinical manifestations. Case presentation We present a case of a 55-year-old, gravida IV para III, Ethiopian woman from Ethiopia with a retained fetus and vesicovaginal fistula after an obstructed labor and a neglected intrauterine fetal demise of approximately 22 years. The diagnosis was confirmed by suggestive clinical history, physical examination findings, and an abdominopelvic computed tomography scan. Laparotomy and removal of the lithopedion was done and our patient was sent to a fistula hospital for vesicovaginal fistula repair. Conclusion This case is a rare phenomenon in which the dead fetus remained in the uterus for a long time after a neglected obstructed labor and uterine rupture.

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