Just interested in thoughts on a particular case I recently experienced.
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A middle-age women experienced numbness of 4th and 5th digits of the left foot only (2 weeks in duration). The patient has a history of type 2 DM of 4 years that is well controlled. The onset of numbness coincided with an interstate flight of around 1 hour in duration. GP precribed aspirin.
O/E: The patient lacked soft touch (protective sensation of all sites of both feet were intact) around 4th and 5th digits. Pain/ allodynia (not paraesthesia) was reproduced with the slump test as the foot was everted. Tinels sign was also evident on percussion of the dorsal cutaneous nerve. Additionally, tinels sign was evident on percussion of the of the dorsal intermediate cutaneous nerve (branch of the superficial peroneal nerve as it passes through the inferior extensor retinaculum).
A preliminary diagnosis of adverse neural tension of the common peroneal nerve and its branches was made. I advised gastroc-soleal, peroneal and hamstring stretches.
Any extra thoughts?
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