Peroneal neuropathy and bariatric surgery: untying the knot

Purpose: Peroneal neuropathy is a neurological complication of bariatric surgery (BS) that can impair the functional capacity of the presenting patient and reduce quality of life. The aim of this paper is to explore and offer medical insight into the presentation, etiologies, and therapeutic modalities of peroneal neuropathy following BS.Methods: We explored PubMed/Medline for cases involving peroneal neuropathy as a complication of BS. The search included all articles published from database inception until April 25, 2019. Only articles published in English were included. Clinical information and demographics extracted from the reported studies were analyzed and assessed.Results: Only 9 studies met our criteria, with a total of 21 cases (n = 21). Females dominated in 14 cases (67%). Ages ranged from 12 to 53 years with mean age being 36. All cases reported pain, numbness and weakness in their lower limb. Gastric bypass was the most common procedure with 9 cases (43%). All cases witnessed loss of a large amount of weight following BS. Amount of weight lost per month ranged from 2.7 kg/month to 19 kg/month. Electrodiagnostic studies were used in 18 cases (86%). Of all the cases presented, 12 (57%) underwent surgical treatment, 7 (33%) underwent conservative treatment, and 2 (10%) resolved spontaneously. All patients reported improvement of symptoms.Conclusion: Better knowledge of the demographics and clinical characteristics of peroneal neuropathy following BS will help in achieving earlier diagnosis and avoiding invasive therapeutic modalities. Guidance with respect to weight reduction is pivotal in deterring similar neurological complications.