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Düşük Ayak Kliniği ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik ve Prognostik Özellikleri

Year 2021, Volume: 4 Issue: 2, 120 - 123, 01.05.2021
https://doi.org/10.19127/bshealthscience.859387

Abstract

Düşük ayağın en sık nedeni peroneal nöropati olup etiyolojide birçok neden vardır. Düşük ayak, kişilerin günlük faaliyetlerini önemli ölçüde etkiler. Bu çalışmada Doğu Anadolu bölgesinde nöroloji polikliniğine düşük ayak kliniği ile başvuran hastaların etiyolojik, elektrofizyolojik ve prognostik özelliklerinin araştırılması amaçlanmıştır. Aralık 2017-Ekim 2019 tarihleri arasında
nörofizyoloji laboratuvarına düşük ayak tanısıyla gönderilen ve tanısı elektronöromyografi ile doğrulanan 18 yaş üstü 80 hastanın verileri geriye dönük olarak incelendi. Tüm analizler SPSS 20 yazılımı kullanılarak yapıldı. Bulgular; Düşük ayak kliniği ile başvuran hastaların cinsiyetler arasında yaş dağılımı benzerdi (P=0,718). Etiyolojide %31,25 (n=25) enjeksiyon, %18,75 (n=15)
kesici/delici/ateşli silahla yaralanma, %16,25 (n=13) radikülopati, %12,5 (n=10) kemik fraktürü, %8,75 (n=7) cerrahi komlplikasyon, %5 (n=4) idiyopatik, %2,5 (n=2) herediter, %2,5 (n=2) metastaz, %2,5 (n=2) kilo kaybı-çömelme vardı. Sinir etkilenimine bakıldığı zaman hastaların (n=80) %86,3’ünde (n=69) peroneal sinir hasarı, %58,8’inde (n=47) tibial sinir hasarı, %57,5’inde (n=46) sural sinir hasarı vardı. Cinsiyete göre bakıldığında peroneal sinir hasarı kadınlarda %78,6 (n=22), erkeklerde %90,4 (n=47), tibial sinir hasarı kadınlarda %64,3 (n=18), erkeklerde %55,7 (n=29), sural sinir hasarı kadınlarda %50 (n=14), erkeklerde %61,5 (n=32) idi. Cinsiyete göre etiyolojik nedenler arasında istatistiksel olarak anlamlı fark vardı (P=0,001). Sonuç olarak nöromusküler yolun tüm yaralanma olasılıkları da dahil olmak üzere hastanın düşük ayak nedeni için kapsamlı bir araştırma yapılmalıdır. Tanı sonrasında düşük ayak ilgili tüm uzmanların dahil olduğu multidisipliner bir yaklaşımla tedavi edilmelidir.

References

  • Altıntaş A, Gündüz A, Kantarcı F, Çelik GG. 2016. Sciatic neuropathy developed after injection during curettage. Agri, 28: 46-48.
  • Aubuchon A, Arnold WD, Bracewell A, Hoyle JC. 2017. Sciatic neuropathy due to popliteal fossa nerve block. Muscle & Nerve, 56(4): 822-824.
  • Cherian RP, Li Y. 2019. Clinical and electrodiagnostic features of nontraumatic sciatic neuropathy. Muscle & Nerve, 59(3): 309-314.
  • Combarros O, Calleja J, Polo J, Berciano J. 1987. Prevalence of hereditary motor and sensory neuropathy in Cantabria. Acta Neur Scandinavica, 75(1): 9-12.
  • Distad BJ, Weiss MD. 2013. Clinical and electrodiagnostic features of sciatic neuropathies. Physical Med Rehab Clin, 24(1): 107-120.
  • Dyck P. 1993. Hereditary motor and sensory neuropathies. Perip Neuropathy, 1993: 1094-1136.
  • Feinberg J, Sethi S. 2006. Sciatic neuropathy: case report and discussion of the literature on postoperative sciatic neuropathy and sciatic nerve tumors. HSS J, 2(2): 181.
  • Ghate J, Ghugrare B, Patond K, Singh R. 2009. The electrophysiological profiles of the footdrop cases: a retrospective study. J MGIMS, 14(2): 36-39.
  • Katirji MB, Wilbourn AJ. 1988. Common peroneal mononeuropathy: a clinical and electrophysiologic study of 116 lesions. Neurology, 38(11): 1723-1723.
  • Kim JY, Do KKSHY. 2015. Isolated painless foot drop due to cerebral infarction mimicking lumbar radiculopathy: A case report. Korean J Spine, 12(3): 210.
  • Kline DG, Kim D, Midha R, Harsh C, Tiel R. 1998. Management and results of sciatic nerve injuries: a 24-year experience. J Neurosurgery, 89(1): 13-23.
  • Kurihara S, Adachi Y, Wada K, Awaki E, Harada H, Nakashima K. 2002. An epidemiological genetic study of Charcot-Marie-Tooth disease in Western Japan. Neuroepidem, 21(5): 246-250.
  • Plewnia C, Wallace C, Zochodne D. 1999. Traumatic sciatic neuropathy: a novel cause, local experience, and a review of the literature. J Trauma and Acute Care Surg, 47(5): 986.
  • Skre H. 1974. Genetic and clinical aspects of Charcot‐Marie‐Tooth's disease. Clinical Gen, 6(2): 98-118.
  • Stewart JD. 2008. Foot drop: where, why and what to do? Practical Neurol, 8(3): 158-169.
  • Toğrol E, Çolak A, Kutlay M, Saraçoğlu M, Akyatan N, Akin ON. 2000. Bilateral peroneal nerve palsy induced by prolonged squatting. Military Med, 165(3): 240-242.
  • Topuz K, Kutlay M, Şimşek H, Atabey C, Demircan M, Şenol Güney M. 2011. Early surgical treatment protocol for sciatic nerve injury due to injection–a retrospective study. British J Neurosurg, 25(4): 509-515.
  • Van Gompel JJ, Griessenauer CJ, Scheithauer BW, Amrami KK, Spinner RJ. 2010. Vascular malformations, rare causes of sciatic neuropathy: a case series. Neurosurg, 67(4): 1133-1142.
  • Wiszniewski W, Szigeti K, Lupski J. 2013. Chapter 126–hereditary motor and sensory neuropathies. Emery and Rimoin’s principles and practice of medical genetics. 6th ed. Academic Press, Oxford, UK, 1-24.

Etiological, Electrophysiological and Prognostic Features of Patients Presenting with Drop Foot Clinic

Year 2021, Volume: 4 Issue: 2, 120 - 123, 01.05.2021
https://doi.org/10.19127/bshealthscience.859387

Abstract

The most common cause of drop foot is peroneal neuropathy, and there are many reasons in etiology. Foot drop markedly restricts the everyday activities of persons. In this study, the etiological, electrophysiological and prognostic features of the patients who applied to the neurology outpatient clinic in the Eastern Anatolia region with drop foot clinic was aimed to investigate. The data
obtained from 80 patients over 18 years of age who were sent to the neurophysiology laboratory with a diagnosis of drop foot between December 2017 and October 2019, and confirmed by electroneuromyography were retrospectively analyzed. All the analyses were made using SPSS 20 software. Results; the age distribution of the patients with drop foot diagnosis was similar between the genders (P=0.718). In etiology there were 31.25% (n=25) injection, 18.75% (n=15) cutter/perforator/gunshot injury, 16.25% (n=13) radiculopathy, 12.5% (n=10) bone fracture, 8.75% (n=7) surgical complication, 5% (n=4) idiopathic, 2.5% (n=2) hereditary, 2.5% (n=2) metastasis, 2.5% (n=2) weight loss-squat. When nerve activation was examined, 86.3% (n=80) of patients (n=69) had peroneal nerve damage, 58.8% (n=47) had tibial nerve damage and 57.5% (n=46) had sural nerve damage. In terms of gender, peroneal nerve damage was 78.6% (n=22) in female and 90.4% (n=47) in male Tibial nerve damage was 64.3% (n=18) in women, 55.7% (n=29) in men. Sural nerve damage was 50% (n=14) in women, 61.5% (n=32) in men. There was a statistically significant difference among causes off according to gender (P=0.001). Consequently, a comprehensive search for the cause of the patient’s drop foot, including all possibilities of injury to the neuromuscular pathway, should be undertaken. After diagnosis, drop foot should be treated with a multidisciplinary approach including all relevant specialists.

References

  • Altıntaş A, Gündüz A, Kantarcı F, Çelik GG. 2016. Sciatic neuropathy developed after injection during curettage. Agri, 28: 46-48.
  • Aubuchon A, Arnold WD, Bracewell A, Hoyle JC. 2017. Sciatic neuropathy due to popliteal fossa nerve block. Muscle & Nerve, 56(4): 822-824.
  • Cherian RP, Li Y. 2019. Clinical and electrodiagnostic features of nontraumatic sciatic neuropathy. Muscle & Nerve, 59(3): 309-314.
  • Combarros O, Calleja J, Polo J, Berciano J. 1987. Prevalence of hereditary motor and sensory neuropathy in Cantabria. Acta Neur Scandinavica, 75(1): 9-12.
  • Distad BJ, Weiss MD. 2013. Clinical and electrodiagnostic features of sciatic neuropathies. Physical Med Rehab Clin, 24(1): 107-120.
  • Dyck P. 1993. Hereditary motor and sensory neuropathies. Perip Neuropathy, 1993: 1094-1136.
  • Feinberg J, Sethi S. 2006. Sciatic neuropathy: case report and discussion of the literature on postoperative sciatic neuropathy and sciatic nerve tumors. HSS J, 2(2): 181.
  • Ghate J, Ghugrare B, Patond K, Singh R. 2009. The electrophysiological profiles of the footdrop cases: a retrospective study. J MGIMS, 14(2): 36-39.
  • Katirji MB, Wilbourn AJ. 1988. Common peroneal mononeuropathy: a clinical and electrophysiologic study of 116 lesions. Neurology, 38(11): 1723-1723.
  • Kim JY, Do KKSHY. 2015. Isolated painless foot drop due to cerebral infarction mimicking lumbar radiculopathy: A case report. Korean J Spine, 12(3): 210.
  • Kline DG, Kim D, Midha R, Harsh C, Tiel R. 1998. Management and results of sciatic nerve injuries: a 24-year experience. J Neurosurgery, 89(1): 13-23.
  • Kurihara S, Adachi Y, Wada K, Awaki E, Harada H, Nakashima K. 2002. An epidemiological genetic study of Charcot-Marie-Tooth disease in Western Japan. Neuroepidem, 21(5): 246-250.
  • Plewnia C, Wallace C, Zochodne D. 1999. Traumatic sciatic neuropathy: a novel cause, local experience, and a review of the literature. J Trauma and Acute Care Surg, 47(5): 986.
  • Skre H. 1974. Genetic and clinical aspects of Charcot‐Marie‐Tooth's disease. Clinical Gen, 6(2): 98-118.
  • Stewart JD. 2008. Foot drop: where, why and what to do? Practical Neurol, 8(3): 158-169.
  • Toğrol E, Çolak A, Kutlay M, Saraçoğlu M, Akyatan N, Akin ON. 2000. Bilateral peroneal nerve palsy induced by prolonged squatting. Military Med, 165(3): 240-242.
  • Topuz K, Kutlay M, Şimşek H, Atabey C, Demircan M, Şenol Güney M. 2011. Early surgical treatment protocol for sciatic nerve injury due to injection–a retrospective study. British J Neurosurg, 25(4): 509-515.
  • Van Gompel JJ, Griessenauer CJ, Scheithauer BW, Amrami KK, Spinner RJ. 2010. Vascular malformations, rare causes of sciatic neuropathy: a case series. Neurosurg, 67(4): 1133-1142.
  • Wiszniewski W, Szigeti K, Lupski J. 2013. Chapter 126–hereditary motor and sensory neuropathies. Emery and Rimoin’s principles and practice of medical genetics. 6th ed. Academic Press, Oxford, UK, 1-24.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences, ​Internal Diseases
Journal Section Research Article
Authors

Fatma Şimşek 0000-0003-1662-5534

Publication Date May 1, 2021
Submission Date January 14, 2021
Acceptance Date January 25, 2021
Published in Issue Year 2021 Volume: 4 Issue: 2

Cite

APA Şimşek, F. (2021). Düşük Ayak Kliniği ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik ve Prognostik Özellikleri. Black Sea Journal of Health Science, 4(2), 120-123. https://doi.org/10.19127/bshealthscience.859387
AMA Şimşek F. Düşük Ayak Kliniği ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik ve Prognostik Özellikleri. BSJ Health Sci. May 2021;4(2):120-123. doi:10.19127/bshealthscience.859387
Chicago Şimşek, Fatma. “Düşük Ayak Kliniği Ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik Ve Prognostik Özellikleri”. Black Sea Journal of Health Science 4, no. 2 (May 2021): 120-23. https://doi.org/10.19127/bshealthscience.859387.
EndNote Şimşek F (May 1, 2021) Düşük Ayak Kliniği ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik ve Prognostik Özellikleri. Black Sea Journal of Health Science 4 2 120–123.
IEEE F. Şimşek, “Düşük Ayak Kliniği ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik ve Prognostik Özellikleri”, BSJ Health Sci., vol. 4, no. 2, pp. 120–123, 2021, doi: 10.19127/bshealthscience.859387.
ISNAD Şimşek, Fatma. “Düşük Ayak Kliniği Ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik Ve Prognostik Özellikleri”. Black Sea Journal of Health Science 4/2 (May 2021), 120-123. https://doi.org/10.19127/bshealthscience.859387.
JAMA Şimşek F. Düşük Ayak Kliniği ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik ve Prognostik Özellikleri. BSJ Health Sci. 2021;4:120–123.
MLA Şimşek, Fatma. “Düşük Ayak Kliniği Ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik Ve Prognostik Özellikleri”. Black Sea Journal of Health Science, vol. 4, no. 2, 2021, pp. 120-3, doi:10.19127/bshealthscience.859387.
Vancouver Şimşek F. Düşük Ayak Kliniği ile Başvuran Hastaların Etiyolojik, Elektrofizyolojik ve Prognostik Özellikleri. BSJ Health Sci. 2021;4(2):120-3.