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

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 arasındanörofizyoloji 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.

Anahtar Kelimeler:

Düşük ayak, Etiyoloji, Peroneal nöropati, Elektromiyografi

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

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 dataobtained 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.

Keywords:

Drop foot, Ethiology, Peroneal neuropathy, Electromyography,

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