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common peroneal neuropathies Needle examination may demonstrate brillation potentials if some axon loss is present This is commonly the case and does not by itself portend a poor prognosis for recovery The most dramatic feature on the needle examination in predominantly demyelinating common peroneal mononeuropathies is the reduced recruitment pattern, proportionate to the degree of conduction block and clinical weakness Isolated deep peroneal and super cial peroneal neuropathies are uncommon Although the deep peroneal nerve has a small sensory branch, it is not readily accessible Reduced CMAP amplitudes of the EDB and tibialis anterior occur, depending on the site of lesion and proportionate to the degree of axon loss With the super cial peroneal nerve, motor conductions are not routinely performed, but the super cial peroneal SNAP would be anticipated to be reduced in amplitude or absent In both cases, needle EMG ndings would be restricted to those muscles innervated by the respective nerves Tibial neuropathies are also uncommon and typically occur at or distal to the knee With axon loss lesions, the CMAP recording from the soleus muscle with H-re ex assessment or a tibial-innervated foot muscle, typically the abductor hallicus, in response to direct tibial nerve stimulation would be reduced in amplitude The sural SNAP may be affected or spared, depending on how proximal the lesion is The mixed plantar responses would be affected with any signi cant axon loss tibial mononeuropathy The electrodiagnostic assessment of a tibial neuropathy at the ankle, ie, the tarsal tunnel syndrome, is a matter of considerable controversy As a potential entrapment neuropathy related to compression by a exor retinaculum, it is a theoretical analog to carpal tunnel syndrome of the upper extremity It either occurs, or is proven to exist infrequently Part of the problem may be technical Even if slowing of tibial nerve conduction through the tarsal tunnel occurs, it is extremely dif cult to demonstrate in the experience of the authors There are a number of potential explanations It is very possible that tarsal tunnel syndrome is a rare syndrome It is equally possible that tarsal tunnel syndrome, unlike carpal tunnel syndrome, has predominantly an axonal pathophysiology in which conduction slowing across exor retinaculum does not occur Lastly, there are technical issues that may play a role Normative data for distal latencies for both tibial motor bers and mixed plantar responses are not as tight as their upper extremity counterparts, thus precluding the detection of mild degrees of focal slowing Mixed plantar responses may be absent in normal individuals Their absence neither proves the existence of nerve injury nor localizes the problem, if one exists, to the tarsal tunnel Fibrillation potentials in tibial-innervated foot muscles may occur in normal individuals Even if pathological, these may more likely represent an early peripheral neuropathy, a.

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