İlker ETİKAN, Betül ÇEVİK, Semiha KURT, Hatice ÜNALDI KARAER, Dürdane AKSOY

Relations between entrapment neuropathies of the lower extremities and Body Mass Index

Amaç. Alt ekstremite tuzak nöropatileri arasında en sık olanlar peroneal nöropati, meralgiaparestetica ve tarsal tünel sendromudur. Üst ekstremite tuzak nöropatilerinde özellikle karpal tünelsendromu ile Vücut Kitle İndeksi ilişkisi konusunda pek çok çalışma yapılmış olmasına rağmen altekstremitede obeziteyle ilişkisi iyi bilinen meralgia parestetica dışında diğer tuzak nöropatileri veVücut Kitle İndeksi ilişkisi belirgin bir şekilde ifade edilmemiştir. Bu çalışmada klinik pratikte sıkkarşımıza çıkan alt ekstremite tuzak nöropatileri ile Vücut Kitle İndeksi ilişkisini araştırmayıamaçladık. Yöntemler. Bu retrospektif çalışmada elektrofizyoloji laboratuvarımıza peronealnöropati, meralgia parestetica ve tarsal tünel sendromu ön tanıları ile gönderilen 204 hastaincelendi. Her grup kendi içinde tuzak nöropatisi olan ve olmayanlar olarak ikiye ayrıldı. Yaş, cinsve Vücut Kitle İndeksi değerleri gruplar arasında karşılaştırıldı. Ayrıca tuzak nöropatisi öntanılıtüm hastalar Vücut Kitle İndekslerine göre 'obez' ve 'obez olmayan' şeklinde 2 gruba ayrıldı vegruplarda tuzak nöropati tipleri ve sıklıkları araştırıldı. Bulgular. Tuzak nöropatisi ön-tanısı ilegelen hastaların yaş ortalamaları 42,61±13,75 idi. Bunların 97si erkek, 107 tanesi kadındı.Toplam 204 hastanın 100'ünde tuzak nöropatisi saptandı. Bunların 39 tanesi peroneal nöropati, 39tanesi meralgia parestetica, 22 tanesi ise tarsal tünel sendromu idi. 'Obez' grubun %93,8'indemeralgia parestetica ön tanısı teyit edildi. Meralgia parestetica tanısı alan hastaların Vücut Kitleİndeksi değerleri meralgia paresteticasi çıkmayan hastalardan anlamlı derecede daha yüksekti.peroneal nöropati, tarsal tünel sendromu saptanan ve saptanmayan hastalar arasında Vücut Kitleİndeksi değerleri açısından anlamlı bir fark saptanmadı. Sonuç. Meralgia parestetica, yüksekVücut Kitle İndeksi ve obezite ile belirgin şekilde ilişkilidir. Az sayıda çalışmada tarsal tünelsendromu ile yüksek Vücut Kitle İndeksi birlikteliğinden ve peroneal nöropati ile kilo kaybıilişkisinden bahsedilmiştir. Bizim çalışmamızda ise peroneal nöropati ve tarsal tünel sendromununobezite ya da zayıflıkla belirgin ilişkisi saptanmamıştır. Ayrıca çalışmamızda meralgia paresteticaoranı yaşla birlikte artış göstermekteydi, ancak bu çalışmada ileri yaş ile peroneal nöropati veyatarsal tünel sendromu arasında anlamlı ilişki saptanmadı.

Alt ekstremite tuzak nörop atileri ve Vücut Kitle İndeksi ilişkisi

Aims. Peroneal neuropathy, meralgia paresthetica and tarsal tunnel syndrome are the mostcommon entrapment neuropathies of the lower extremities. Although, the effect of Body MassIndex on the entrapment neuropathies of the upper extremities, especially carpal tunnel syndrome,has been studied extensively, its effect on the entrapment neuropathies of the lower extremities,except meralgia paresthetica which is well known to be associated with obesity, is not wellunderstood. In this study, we aimed to investigate the relations between Body Mass Index and thecommon entrapment neurophaties of the lower extremities. Methods. This retrospective studyfocused on 204 patients that were referred to our electrophysiology laboratory with a pre-diagnosisof peroneal neuropathy, meralgia paresthetica, and tarsal tunnel syndrome. Each group is separatedinto two subgroups consisting of patients with and without entrapment neuropathy. Age, sex, andBody Mass Index values are compared amongst the groups. In addition, all of the patients with apre-diagnosis of entrapment neuropathy are further divided into two subgroups based on theirBody Mass Index as obese and non-obese patients, and type and frequency of entrapmentneuropathies are investigated. Results. The mean age of the patients pre-diagnosed withentrapment neuropathy was 42.61± 13.75. There were 97 men and 107 women. Of the 100 patientsthat were verified to have entrapment neuropathy, 39 were diagnosed with peroneal neuropathy, 39with meralgia paresthetica and remaining 22 with tarsal tunnel syndrome. 93.8% of the obesepatients who admitted with the pre-diagnosis of meralgia paresthetica were confirmed to have thisdiagnosis. Body Mass Index values of the patients with verified meralgia paresthetica weresignificantly higher than those of the patients who were found not to have meralgia paresthetica.There were no significant differences regarding Body Mass Index values between the patients withand without peroneal neuropathy or tarsal tunnel syndrome. Conclusion. It is suggested thatmeralgia paresthetica is related to high Body Mass Index and obesity. Very limited number of thepast studies mentioned associations between high Body Mass Index and tarsal tunnel syndrome,and weight loss and peroneal neuropathy. In this investigation, no significant association wasfound between obesity or emaciation and peroneal neuropathy or tarsal tunnel syndrome. Inaddition, the rate of meralgia paresthetica was higher in patients with advanced age, but there wasno significant relationship between advancing age and peroneal neuropathy or tarsal tunnelsyndrome in this study.

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