[Ischemic neuropathy in occlusive lower limb arterial disease at the state of ischemia on effort].
Acute or chronic prolonged ischaemia of the limbs may cause lasting neurological damage. This has been shown in clinical, electrophysiological and anatomopathological studies. The aim of this study was to search for signs of neurological suffering during ischaemia of effort. Twenty patients with occlusive lower limb arterial disease with ischaemia of effort were studied. None of the patients had other causes of neuropathy: none of the patients had potentially neurotoxic therapy. All underwent haemodynamic assessment (Doppler ultrasonography treadmill test, transcutaneous oxygen diffusion) and electrophysiological study (nerve conduction studies and an electromyogramme). Ten patients had abnormalities during stimulation-detection and on electromyography. These abnormalities were always observed in the limbs with the poorest blood flow. The pressure index and transcutaneous oxygen diffusion in lying position were significantly lower (pressure index: 0.43 vs 0.72, p < 0.03; TcPO2: 20.3 vs 27.2, p < 0.04). The authors consider that effort ischaemia is associated with neurological damage. Repeated transient episodes of ischaemia could cause neuropathy.
Lacroix
P
P
Service de chirurgie thoraco-vasculaire et angiologie, CHRU Dupuytren, Limoges.
Aboyans
V
V
Fournier
S
S
Salles
J Y
JY
Cornu
E
E
Laskar
M
M
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications*; D004576:Electromyography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007511:Ischemia / Q000150:complications*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000473:pathology
D010100:Oxygen
Neuropathies ischémiques dans l'artériopthie oblitérante des membres inférieurs au stade d'ischémie d'effort.