Ischemic neuropathy in occlusive lower limb arterial disease at the state of ischemia on effort
Lacroix, P.; Aboyans, V.; Fournier, S.; Salles, J.Y.; Cornu, E.; Laskar, M.
Archives des Maladies du Coeur et des Vaisseaux 92(11): 1471-1475
1999
ISSN/ISBN: 0003-9683 PMID: 10598226 Document Number: 512077
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.