Slimmer’s palsy following an intermittent fasting diet

Abstract

Abstract Background Isolated common peroneal neuropathy (CPN) is the most common lower extremity mononeuropathy and the third most common mononeuropathy overall in adults. It often associated with multiple aetiologies, such as trauma, hereditary neuropathies and iatrogenic causes. We report a rare case of acute bilateral foot drop in a late adolescent female following a rapid weight loss attributable to intermittent fasting diet. Case presentation A 19-year-old female presented with worsening bilateral foot drop following a rapid intentional weight loss by intermittent fasting diet. She lost 20% of her baseline bodyweight within a period of 4 months. Systemic disease and metabolic screenings for neuropathy differentials were unremarkable. Electrophysiological studies revealed severe entrapment neuropathy involving bilateral common peroneal nerves (CPN). Her confounding risk factors for CPN injury include contact sport activities and habitual leg crossing during sitting. Following a dietary modification and physical therapy she achieved complete recovery of weakness and function on follow-up. Conclusions In a patient with bilateral PN rapid weight loss, prognosis is good and complete neurologic recovery can be attained through combination of cessation of extreme diet and physical therapy.