Practice: The authors suggested EDX studies that may be useful for making or confirming diagnoses in patients with suspected peroneal neuropathy. In particular:
motor NCSs of the peroneal nerve recording from the anterior tibialis and extensor digitorum brevis muscles, including assessment of peroneal conduction through the leg and across the fibular head;
orthodromic and antidromic superficial peroneal NCSs; and
at least one additional normal motor and sensory NCS in the same limb, to assure that the peroneal neuropathy is isolated and not systemic.
The authors also stated that data are insufficient to determine the role of needle EMG in diagnosis. However, abnormalities outside the distribution of the peroneal nerve should suggest alternative or additional diagnoses.
Research: The authors made recommendations for future research. In particular:
standardised, consensus-based criteria are needed for diagnosis and degree of clinical severity;
future studies should be prospective and include a spectrum of participants with competing diagnoses and varying degrees of clinical severity;
those performing and interpreting investigations should be blinded to the clinical diagnosis;
techniques should be adequately described, limb temperature should be monitored during studies, normal values for the investigation should be derived from a reference population, and the threshold for abnormality should be defined in advance; and
studies should use tests and procedures widely available and useful in a practice setting.
In addition, further studies on segmental conduction across the fibular head region, and on the impact of EDX techniques on the costs, treatment and outcomes of patients, are needed.