Foot Drop
July 1st, 2019
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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