A Case of Foot Drop as an Expression of Brain Metastases?

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Neurologist. 2006 Sep;12(5):274-275.

A Case of Foot Drop as an Expression of Brain Metastases?

Djekidel M, Harb W.

From *Westland, Michigan; and the daggerDepartment of Medical

Education, Oakwood Hospital, Dearborn, Michigan.

Foot drop can be defined as a significant weakness in ankle and toe

dorsiflexion. Injury to the dorsiflexors or to any point along the

neural pathways that supply these muscles can result in a foot drop.

Injury to the peroneal nerve is usually the major precipitant. Other

causes vary from trauma to surgical nerve injury, as well as leg

compartment syndromes or dorsiflexor injuries, peripheral nerve

injuries, stroke, neuropathies, drug toxicities, spinal stenosis, L5

sciaticas, systemic diseases such as connective tissue diseases,

vasculidities, or diabetes.

This report focuses on a patient presenting with a foot drop as an

unusual manifestation of brain metastasis. His minimal

symptomatology seemed to point towards a local process. Therefore,

early recognition and prompt treatment are essential. The central

nervous system must be the target of investigations when the workup

fails to disclose the proper etiology. Potential diagnostic delays

may occur. Certain cases may require a more aggressive approach.