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Vascular Insufficiency Quantitatively Aggravates Diabetic Neuropathy
Zvi Ram, MD;
Menachem Sadeh, MD;
Raphael Walden, MD;
Raphael Adar, MD
Arch Neurol. 1991;48(12):1239-1242.
Abstract
• The effect of lower-limb ischemia on the severity of neuropathy was examined in 48 diabetic patients with peripheral vascular disease. The severity of the vascular disease, as determined by medical history, physical findings, and laboratory data, was scored for each leg. Neuropathy was rated clinically and based on the results of nerve conduction studies of the common peroneal, posterior tibial, and sural nerves. A significant correlation was found between the vascular scores and neurologic variables of the two legs, most strikingly so in electrophysiologic data, with coefficients of .6 to .7. Nondiabetic control patients showed no evidence of neuropathy, regardless of the severity of ischemia, whereas diabetic controls without limb ischemia showed symmetrical neuropathy. These findings support the hypoxic theory in the pathogenesis of diabetic neuropathy.
Author Affiliations
From the Departments of Neurosurgery (Dr Ram), Neurology (Dr Sadeh), and Vascular Surgery (Drs Walden and Adar), The Chaim Sheba Medical Center, Tel-Hashomer, and the Sackler School of Medicine, Israel.
Footnotes
Accepted for publication May 7, 1991.
Reprint requests to the Department of Neurosurgery, The Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel (Dr Ram).
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