FOOTdro‎p IN THE FARMERS: CLINICAL an‎d ELECTROMYOGRAPHICAL STUDY

Footdrop is a relatively common deficit among the neurological disorders, which has different causes with various levels of involvement in neuromuscular system, including central nervous system (brain cortex, spinal cord), fifth lumbar root, peripheral nerves and muscles. Peroneal nerve injury at the fibular head has been reported to be the most common cause of footdrop, which can be due to infarct, tumor or leprosy but the vast majority of lesions are traumatic .In this article, we report seventeen patients with footdrop in farmers . All of the patients except one, were male with age ranges between 15 to 25 years. They had been doing certain farming activities (harvesting or weeding ) for 1–5 days before developing footdrop. Electrophysiological studies have been done in only seven of them due to patient’s unwillingness. Nerve conduction velocity and amplitudes distal to the fibular head were normal, but stimulation above the fibular head showed reduced nerve conduction velocity and amplitudes (mean 22.4 m/s in the abnormal side versus 51.5 m/s in the normal side, mean peak to peak amplitude 3.6 mv in the symptomatic side versus 10.4 in the contralateral side respectively). Forty-three percent of patients had also conduction block. F wave latency increased on the affected side in comparison to the normal side (mean 4.7 m/s). The new and perhaps interesting findings in our cases are unilateral involvement and occurrence of peroneal palsy on the side of dominent hand, indicating that type of the hand activity is probably more important in inducing footdrop than the position of seating during harvesting or weeding. We suggest further investigation in this setting in order to find the mechanisms of nerve injury and prophylactic measures.