ISSN 2398-2969      

Tibial neuropathy

icanis
Contributor(s):

Paul Cuddon


Introduction

  • Cause:
    • Iatrogenic damage to nerve, eg misplaced or irritant injections into caudal thigh muscles.
    • Congenital tibial and peroneal neuropathy in unweaned Walker hound puppies.
    • Peripheral nerve neoplasia.
  • Signs: unable to extend hock or flex the toes, plantigrade stance, no sensation on plantar aspect of metatarsus and digits.
  • Diagnosis: signs, electrophysiology - EMG, nerve conduction studies.
  • Treatment: physiotherapy. If tibial nerve is entrapped by scar tissue, surgical release of the nerve is indicated.
  • Prognosis: depends on severity - good to poor.

Pathogenesis

Etiology

  • Iatrogenic - injection injury, (damage may result from needle puncture, the drug deposited, pressure from hematoma, or scarring round the nerve). Surgery to tibia.
  • Trauma to tibia, eg fracture.
  • Neoplasia.

Pathophysiology

  • Misplaced or irritant injection into caudal thigh muscles → direct trauma, inflammation of nerve, pressure from a hematoma or scarring → disrupted neural elements → loss of function of extensor muscles to hock and flexors to toes → loss of sensation to plantar aspect of metatarsus and digits → neurogenic muscle atrophy of hock extensors and toe flexors, (gastrocnemius and interosseus muscles respectively.)

Timecourse

  • Immediately after injury - loss of function.
  • 7-10 days after injury - beginning of muscle atrophy.
  • Slowly progressive if peripheral nerve tumor.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bailey C S, Kitchell R L (1987) Cutaneous sensory testing in the dog. JVIM (3), 128-135 PubMed.

Other sources of information

  • Summers B Aet al(1995)diseases of the peripheral nervous system.In:Veterinary Neuropathology.Mosby pp 402-501.
  • Braund K G (1994)Clinical syndromes in veterinary neurology.Mosby pp 277-279.

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