Incidence of peripheral neuropathy in the contralateral limb of persons with unilateral amputation due to diabetes.
Eighty persons with first-time, nontraumatic amputation, mean age 66.7 yrs +/- 12.6 (1 SD) were examined to determine the extent of peripheral neuropathy (PN) present in the intact limb. Thirty-eight (47.5%) of the subjects had confirmed diabetes mellitus (DM); in those subjects, vibration sense (73.3%), temperature sense (42.1%), and nociception (71.1%) were decreased or absent in the intact limb. The prevalence of sensory impairment was significantly less in nondiabetic subjects in whom vibration sense 46.5% (p < 0.02), temperature sense 16.3% (p < 0.01), and nociception 32.6% (p < 0.02) were decreased or absent. Using a scale that stages the severity of PN, a significant difference (p < 0.001) in the distribution was found between these two groups. Only one person with known DM had no evidence of PN. Twenty-eight out of 42 nondiabetic subjects had evidence of PN. Eighty percent of all subjects had PN. This study confirms the significant potential for PN in persons with DM and presents new evidence of a significant incidence of neuropathy in nondiabetic individuals with amputation. The finding of unexpected peripheral nerve compromise is an important consideration in the treatment of persons with peripheral vascular disease who are at risk for amputation and for persons with amputation who depend on the intact limb for stability and ambulation.
Department of Physical Medicine and Rehabilitation, Parkwood Hospital, University of Western Ontario, London, Canada.
P J
PJ
Potter
O
O
Maryniak
R
R
Yaworski
I C
IC
Jones
D000368:Aged; D000671:Amputation, Surgical; D003925:Diabetic Angiopathies / Q000150:complications* / Q000601:surgery*; D003929:Diabetic Neuropathies / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies