Neuropathie van de voet

Neuropathie van de voet (Engels: Peripheral neuropathy in the feet) is een neurologische aandoening die zich manifesteert door gevoelsoverlast, pijn en gebreken in de sensoriele functies van de voeten. Deze aandoening treedt meestal op als gevolg van ziektes, waaronder diabetes mellitus, sclerose myelinotica en cancer, of als zijnde bijwerking van bepaalde geneesmiddelen, waaronder chemotherapeutica.

Verwante onderwerpen

• Periferale neuropathie
• Blog: Perifere neuropathes
• Cancer neuropathie
• Chimiotherapie geïnduceerde perifere neuropathie
• Diabetische voetneuropatie
• Diabetes mellitus
• Sclerose myelinotica
• Voetdiabetes
• Voetpijn
• Weggewaar voor voetproblemen bij diabetici

Symptomen

De symptomen van neuropathie van de voet kunnen verschillen, afhankelijk van het type neuropathie dat aanwezig is en de ernst van de aandoening. Echter, er bestaat een aantal gemeenschappelijke symptomen waaronder: gevoeligheidstoetsen verzwakt of geheel verloren; gevoelsoverlast (hyperesthesie); pijn; zwellingen in de voeten; koudvoeten; bloedingen in de voeten; en huidopslag. Deze symptomen kunnen leiden tot risico's voor aandoeningen zoals ontstekingscijfers (swelling and infection).

Behandeling

De behandeling van neuropathie van de voet hangt af van de oorzaak van de aandoening. Er zijn geen specifieke geneesmiddelen om neuropathie te genezen, maar sommige medicatie kan helpen met de symptomen. Bij chemotherapie gerelateerde neuropathie kan symptoombestrijdingsmedicatie zoals gabapentin en pregabalin worden voorgeschreven. Bijvoorbeeld, bij diabetes mellitus gerelateerde neuropathie kan behandeling bestaan uit medicatie die mogelijke risicofactoren tegengaat zoals geuniberangulatiofietsedrukverlagers (antihypertensiva). Daarnaast zijn er niet-medicinale wijzen om symptomen te verlichten zoals terugkeer naar een goede voeteigenwijze, regulering van het bloedsuikerpeil en fysiotherapie.

Voorkomen

Er bestaan geen absolute manieren om neuropathie van de voet te voorkomen, aangezien dit ziektes laatste stadium heeft bereikt, maar ceteris paribus inzetten op preventieve maatregelen zoals goede voedingsvoorschriften en regelmatige ervaringen kan helpen om deze aandoening te voorkomen of uit te stellen. Ook moet men continu toezicht houden op het volgen van medisch advies om noodzakelijke maatregelen snel in te gaan bij eventuele problemen die kunnen optreden. Diabetici zullen binnen hun preventieve heelprogramma's leren over prevention en zelfcontrole van hun echtheidiwigheid, hun eigenbloedsuikersneltests en benutten van diploominderheidswerkten. Met name diabetici met complicaties hebben hun owndragerspelicjalisten die proactief remedies zoeken om complexe klinische situaties aan te pakken.

Critical Illness Neuropathy (CIN)

Critical Illness Neuropathy (CIN) is a type of neuropathy that can occur in patients during, or shortly after, a critical illness. It is characterized by motor and sensory nerve damage, leading to symptoms such as muscle weakness, numbness, and pain in various parts of the body.

Epidemiology

CIN is relatively rare, with an incidence of 4-56% among patients in intensive care units (ICUs). It can occur in any age group but is more common in adults. The exact prevalence is hard to determine due to the variety of diagnostic criteria and the potential underdiagnosis of the condition.

Causes

The exact causes of CIN are not fully understood. However, it is believed to be a result of a combination of factors, including systemic inflammation, metabolic disturbances, immune-mediated mechanisms, and direct nerve injury. Critical illnesses that have been associated with CIN include sepsis, traumatic brain injury, Guillain-Barré syndrome, and burn injuries.

Clinical Features

The symptoms of CIN can vary widely depending on the location and severity of the nerve damage. Common symptoms include:

1. Motor symptoms: Weakness, paralysis, and loss of reflexes in the affected muscles. This can affect various parts of the body, including the arms, legs, and respiratory muscles.
2. Sensory symptoms: Numbness, tingling, or pain in the affected areas. This can also lead to loss of sensation and hypersensitivity.
3. Autonomic symptoms: Changes in blood pressure, heart rate, temperature regulation, and digestive function. These symptoms are less common but can be severe.

Diagnosis

Diagnosis of CIN can be challenging due to the varying symptoms and the presence of other complications in critically ill patients. The diagnosis is typically based on a combination of clinical examination, nerve conduction studies (NCV), electromyography (EMG), and imaging studies such as MRI or CT scans. However, these tests may not always provide definitive answers and may need to be repeated over time.

Treatment and Prognosis

Treatment of CIN is mainly supportive and aimed at managing symptoms and preventing further nerve damage. This may involve physical therapy, medication for pain management, and nutritional support. There is currently no specific treatment proven to reverse nerve damage caused by CIN. The prognosis varies widely, with some patients making a full recovery while others may experience long-term disability.

Related Topics

Diabetic Peripheral Neuropathy Medications

Diabetic peripheral neuropathy (DPN) is another common form of neuropathy, often occurring in patients with diabetes mellitus. Although CIN and DPN share some similarities, their causes and treatments are different. For DPN, several medications are available to help manage symptoms and slow progression, including antidepressants, anticonvulsants, and analgesics.

Neuropathy Diagnosis

The diagnosis of neuropathy generally involves a combination of clinical examination, NCV, EMG, and blood tests to identify potential underlying causes such as vitamin deficiencies or diabetes. The specific diagnostic tests used may vary depending on the suspected cause and location of the neuropathy.

Neuropathy Feet Symptoms

Neuropathy can affect the feet through damage to the nerves responsible for sensation and motor control. Common symptoms include numbness, tingling, burning pain, foot ulcers, and altered gait due to muscle weakness. Careful foot care is essential to prevent complications such as infection and ulceration.

Shoes for Neuropathy Feet

Shoes designed for neuropathy feet are characterized by features such as wide toe boxes to accommodate swelling, proper cushioning for shock absorption, and non-slip soles for stability. These shoes can help protect the feet from injury and discomfort caused by neuropathy.

Hand Neuropathy

Hand neuropathy refers to damage to the nerves supplying the hand, leading to symptoms such as numbness, tingling, weakness, and muscle wasting. Carpal tunnel syndrome is a common example of hand neuropathy caused by compression of the median nerve at the wrist. Treatment may involve splinting, corticosteroid injections, or surgery in severe cases.