Çağdaş BALCI, Ülkü MERAL, Dinçay ULUÇ, Handan Işın ÖZIŞIK KARAMAN

Cerrahi ile Hızlı Düzelme Gösteren Nadir Bir Peroneal Sinir Tuzak Nöropatisi Sebebi: Obezite Cerrahisi

Obezite Cerrahisi sonrası çeşitli nörolojik komplikasyonlar gelişebilir. Bu komplikasyonlardan biri olan düşük ayak gelişen iki olguda, NCV/EMG incelemesinde fibula başında peroneal sinir tuzak nöropatisi saptandı. Progresif klinik seyri olan olgulara sinir dekompresyon cerrahisi uygulandı. Her iki olgu, uygun fizyoterapi ve mikronutrient desteği ile birlikte cerrahi sonrası birinci ayda tama yakın iyileşti. Obezite cerrahisinin uzun dönem komplikasyonları arasında mononöropati vakaları sıktır. İlerleyici vakalarda dekompresyon cerrahisi tedavi seçenekleri arasında yer alır. Dekompresyon cerrahisi uygulanan ve başarılı sonuç elde edilen iki peroneal mononöropati olgusu, obezite cerrahisi sonrası gelişebilecek bu komplikasyona dikkat çekmek amacıyla sunuldu.

Anahtar Kelimeler:

Obezite cerrahisi, Düşük ayak, Peroneal nöropati, Sinir dekompresyon cerrahisi.

A Rare Cause of Peroneal Nerve Entrapment Neuropathy With Rapid Recovery With Surgery: Obesity Surgery

Various neurological complications may develop, after obesity surgery. Peroneal nerve entrapment neuropathy was detected in the head of the fibula at the NCV/EMG examination in the two cases with one of these complications, footdrop. Nerve decompression surgery was applied to cases with progressive clinical course. Both cases were treated with appropriate physiotherapy and micronutrient supplementation in the first month after surgery. Mononeuropathy is a common long-term complication of obesity surgery. Decompression surgery is a treatment option in progressive cases. Two peroneal mononeuropathy cases with decompression surgery and successful results were presented to draw attention to this complication that may develop after obesity surgery

Keywords:

Obesity surgery, Drop foot, Peroneal neuropathy, Nevre decompression surgery,

PDF

___

1. Shahar E, et al. Adolescence peroneal neuropathy associated with rapid marked weight reduction: Case report and literature review. Eur J Paediatr Neurol. 2007;11(1):50-54.
2. Garg B, Poage C. Peroneal nerve palsy: Evaluation and management. J Am Acad Orthop Surg. 2016;24(5):e49.
3. Aprile I, et al. Multicenter study of peroneal mononeuropathy: Clinical, neurophysiologic, and quality of life assessment. J Peripher Nerv Syst. 2005;10(3):259-268.
4. Lutte I, et al. Peroneal nerve palsy in anorexia nervosa. Acta Neurol Belg. 1997;97(4):251-254.
5. Papagianni A, et al. Clinical and neurophysiological study of peroneal nerve mononeuropathy after substantial weight loss in patients suffering from major depressive and schizophrenic disorder: Suggestions on patients’ management. J Brachial Plex Peripher Nerve Inj. 2008;3:24.
6. Şencan R, et al. Bilateral peroneal neuropathy after obesity surgery. 2015;21(3):110-111.
7. Hill JO, et al. Introduction. Nutr Rev. 2001;59:4-6.
8. Uğur K, ve ark. Obezitenin tanımı, epidemiyolojisi ve klinik önemi. Defin Epidemiol Clin Importance Obesity. 2016;9(2):1- 7.
9. Must A, et al. The disease burden associated with overweight and obesity. JAMA. 1999;282(16):1523-1529.
10. Sevinçer GM, ve ark. Bariatrik cerrahinin psikiyatrik ve psikososyal yönleri. Psychiatr Psychosoc Asp Bariatr Surgery. 2014;6(1):32-44.
11. Çaycı H, Erdogdu UE. Laparoscopic sleeve gastrectomy versus endoscopical intra-gastric balloon placement: Early results of morbidly obese patients. Arch Clin Exp Med. 2017;2(2):35-38.
12. Abarbanel JM, et al. Neurologic complications after gastric restriction surgery for morbid obesity. Neurology. 1987;37(2):196-200.
13. Thaisetthawatkul P, et al. A controlled study of peripheral neuropathy after bariatric surgery. Neurology. 2004;63(8):1462- 1470.
14. Zhen CAC, et al. Peroneal palsy after bariatric surgery. Saudi J Laparosc. 2016;1(1):9-12.
15. Weyns FJM, et al. Foot drop as a complication of weight loss after bariatric surgery: Is it preventable? Obes Surg. 2007;17(9):1209-1212.
16. Erol V, ve ark. Laparoskopik Sleeve Gastrektomi sonrası gelişen periferik nöropati ve tedavi yönetimi. Cerrahi Sanatlar Dergisi. 2016;9(1): 35-39.
17. Koffman BM, et al. Neurologic complications after surgery for obesity. Muscle Nerve. 2006;33(2):166-176.
18. Ramos-Levi AM, et al. Peroneal palsy after bariatric surgery; is nerve decompresion always necessary? Nutr Hosp. 2013;28:1330-1332.
19. Karadag Y, et al. An underestimated complication of obesity management: Bilateral peroneal neuropathy. Journal of Neurological Sciences. 2013;30(4):801-804.
20. Prado MP. Developed foot drop as a complication of bariatric surgery: Case reports. Einstein (São Paulo). 2010;8:232-234.
21. Masakado Y, et al. Clinical neurophysiology in the diagnosis of peroneal nerve palsy. Keio J Med. 2008;57(2):84-89.