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Pyrex Journal of Educational Research and Reviews(PJERR)

August 2016 Vol. 2(4), pp. 34-36

ISSN: 2985- 8879

Copyright 2016 Pyrex Journals




Review Paper


Tarsal Tunnel Syndrome in Iraqi Patients with Type 2 Diabetes Mellitus


Safaa Hussein Ali

Al Mustansiriya College of Medicine, Baghdad, Iraq.

Corresponding Author E-mail: safaalshammary@yahoo.com

Accepted 18th August, 2016



Abstract


Background: Diabetic patients often present with distressing symptoms such as pain and burning dysthesia in the feet. The present study was designed to estimate the point prevalence of tarsal tunnel syndrome (TTS) in a population of subjects with diabetes and to identify the most valid electrodiagnostic test for discriminating TTS from diabetic peripheral polyneuropathy (DPN) in different stages of severity of DPN. Diagnosis of TTS in patients with DPN is important, as therapeutic interventions directed toward relief of TTS may be effective irrespective of diffuse neuropathy. Method: In this study a group of 35 normal volunteers who had no neurological complaints or foot trauma were selected, and 78 patients having longstanding diabetes mellitus with complaints of distressing pain, burning sensation and paresthesias in the feet were selected for electrophysiological tests where bilateral tibial distal motor latencies to both the AHB and ADQP, for the medial and lateral plantar nerves, respectively, stimulating the tibial nerve proximal to the tarsal tunnel at the medial malleolus, medial and lateral plantar sensory responses were studied. Results: In the present study we observed that 60 (77%) of diabetic cases showed abnormal findings, e.g. prolonged distal motor latency, decreased amplitude of M-response, low or absent sensory response suggesting TTS. Conclusion: This study shows that TTS may be present in a significant number of diabetic patients with subjective neuropathic symptoms in the feet. It is essential to investigate more localized reasons like TTS that may mimic diabetic neuropathy and it should be considered in diagnostic workup and the management of diabetes mellitus.

Keywords: (tarsal tunnel syndrome, diabetes mellitus, medial plantar nerve , nerve conduction study, entrapment neuropathy).

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