Klein Sandra E, Chu Jennifer, McCormick Jeremy J, Johnson Jeffrey E
Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO, USA
Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO, USA Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Foot Ankle Int. 2015 Sep;36(9):1058-63. doi: 10.1177/1071100715583352. Epub 2015 May 12.
The foot and ankle surgeon can see peripheral neuropathy in the treatment of foot and ankle conditions. The purpose of this study was (1) to evaluate the demographics and presenting complaints of patients diagnosed with idiopathic peripheral neuropathy during an examination by a foot and ankle surgeon and (2) to identify the type and frequency of subsequent diagnosis of medical causes of neuropathy.
This was a retrospective study of patients diagnosed with idiopathic peripheral neuropathy in our practice between January 1997 and December 2008. Ninety-five patients were identified, and demographic data, presenting complaints, and medical comorbidities were extracted from the medical record. Examination findings of decreased sensation to Semmes Weinstein 5.07 monofilament testing were documented, and electromyogram and nerve conduction study results were reviewed when available. Laboratory values were noted, as were neurologic evaluations performed to diagnose medical conditions associated with peripheral neuropathy.
The most common presentation was foot pain, in 36 patients (38%). Ninety-one patients had Semmes Weinstein 5.07 monofilament testing, with loss of protective sensation reported in 75 of the 91 tested (82%). Only 30 of the 95 patients had electromyogram and nerve conduction study results available, with a test positive for peripheral neuropathy in 20 of the 30 tested. Thirty-two patients were evaluated by a neurologist. A specific cause was identified in 12 of the 32 seen by a neurologist. Of the total group of 95 patients, 31 patients (33%) were diagnosed with a condition that may be associated with peripheral neuropathy.
Thirty-three percent of the patients presenting to our clinic and given a diagnosis of idiopathic peripheral neuropathy were ultimately diagnosed with a medical cause of neuropathy-most commonly, diabetes. For those patients with idiopathic neuropathy, a spectrum of disease was encountered, including pain, ulcer, infection, and Charcot neuroarthropathy.
Level IV, retrospective case series.
足踝外科医生在治疗足踝疾病时会遇到周围神经病变。本研究的目的是：（1）评估在足踝外科医生检查期间被诊断为特发性周围神经病变患者的人口统计学特征和就诊主诉；（2）确定随后诊断出的神经病变病因类型及频率。
这是一项对1997年1月至2008年12月期间在我们诊所被诊断为特发性周围神经病变患者的回顾性研究。共识别出95例患者，并从病历中提取人口统计学数据、就诊主诉和内科合并症。记录Semmes Weinstein 5.07单丝试验感觉减退的检查结果，如有可用的肌电图和神经传导研究结果也进行回顾。记录实验室检查值以及为诊断与周围神经病变相关的内科疾病而进行的神经学评估。
最常见的表现是足部疼痛，36例患者（38%）有此症状。91例患者进行了Semmes Weinstein 5.07单丝试验，91例受试患者中有75例（82%）报告存在保护性感觉丧失。95例患者中只有30例有肌电图和神经传导研究结果，30例受试患者中有20例周围神经病变检查呈阳性。32例患者接受了神经科医生的评估。32例接受神经科医生评估的患者中有12例确定了具体病因。在95例患者的总体中，31例患者（33%）被诊断出可能与周围神经病变相关的疾病。
到我们诊所就诊并被诊断为特发性周围神经病变的患者中，33%最终被诊断出有神经病变的病因，最常见的是糖尿病。对于那些特发性神经病变患者，遇到了一系列疾病，包括疼痛、溃疡、感染和夏科氏神经关节病。
IV级，回顾性病例系列。
