Twenty-nine-year stimulation of the common peroneal nerve in a hemiplegic patient

Functional electrical stimulation (FES) of the common peroneal nerve (CPN), to correct gait, has been shown to be a useful means for the restoration of functional movement in the lower extremities of hemiplegic individuals. Motor function over a twenty-nine year period of selective stimulation of the CPN with an implantable stimulator to correct drop-foot in a 56 year old patient with left-sided hemiplegia, was evaluated. Partial restoration of dorsal flexion and well balanced eversion of the affected foot was achieved by selective stimulation of superficial region of the CPN innervating mostly the tibialis anterior and partly peroneus longus and peroneus brevis muscles. It was shown that the system is suitable for very long-term FES providing improved muscle function. Namely, even after 29 years of daily FES of the CPN, a functional and reliable recruitment of fibres within the CPN was still achieved, thus providing an appropriate dorsal flexion and eversion of the affected foot. It was found that the stimulation-associated-mechanical trauma to the CPN elicited some minor non-age-related loss of the larger myelinated nerve fibres. Electrophysiological and biomechanical measurements however, have not revealed any functional signs which could be attributed to the damage of the CPN.