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Foot Drop



    • Look For

    • Foot drop splints (around the room or on the patient)
    • High-stepping gait
    • Inability to heel walk
    • Weakness on dorsiflexion of the ankle
    • Causes of Foot Drop

    • Central Nervous System

    • CNS lesion - ischaemia, haemorrhage, tumour, trauma, multiple sclerosis, infection, vasculitis
    • Peripheral Nerves

    • L5 nerve root lesion - radiculopathy, spinal trauma, tumour
    • Common peroneal nerve palsy - compression, trauma, tumour
    • Mononeuritis multiplex - vasculitis, diabetic neuropathy, infection, paraneoplastic
    • Peripheral polyneuropathy - Charcot-Marie-Tooth, Guillain Barre, CIDP, motor neurone disease, polio
    • Other

    • Myopathy - inflammatory myositis, muscular dystrophy, paraneoplastic
    • Interpretation

    • Unilateral foot drop - suggests a common peroneal nerve or L5 nerve root lesion
    • Bilateral foot drop - suggests peripheral polyneuropathy, or less commonly muscular pathology
    • Associated weakness of hip abduction - suggests an L5 nerve root lesion, rather than a common peroneal nerve lesion
    • Associated weakness of foot eversion - suggests a common peroneal nerve lesion, rather than an L5 nerve root lesion
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