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Signs
 
 

Foot Drop

 
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Overview

  • 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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