Diabetic neuropathic pain in a leg amputated 44 years previously
Diabetic neuropathic pain in a leg amputated 44 years previously
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DOI：
10.1016/s0304-3959(99)00163-3
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发表时间：
1999-12-01
期刊：
影响因子：
7.4
通讯作者：
Ward, JD
中科院分区：
文献类型：
--
作者：
Rajbhandari, SM;Jarratt, JA;Ward, JD
糖尿病肢体神经病理性疼痛的机制尚不清楚。幻肢痛的病因同样不清楚。一位糖尿病患者在截肢多年后，在一条缺席的腿上出现了典型的疼痛，这不仅激发了人们对神经性疼痛机制的思考，也激发了对幻肢痛机制的思考。一名58岁的男子在13岁时因先天性AV畸形接受左膝下截肢术44年后被诊断为2型糖尿病。在诊断为糖尿病前8个月，他开始主诉截肢侧腿部疼痛，疼痛与典型的糖尿病神经病变非常相似。随后右腿出现类似疼痛。脊柱MR扫描显示，除了左侧L-5/S-1水平的椎间盘突出外，还存在胸髓的小脊髓水肿，这是5年前首次发现的。没有S-1压缩的其他特征。与2型糖尿病诊断相关的截肢和完整肢体疼痛的典型神经病理特征表明，神经病理性疼痛可能起源于高于外周神经的中枢。(C)1999年国际疼痛研究协会。出版社：Elsevier Science B. V.
The mechanism of neuropathic pain in the diabetic limb is far from clear. Phantom limb pain likewise is of obscure aetiology. The development of typical pain in an absent leg in a patient with diabetes many years after the amputation stimulates thought as to the mechanism, not only of neuropathic pain, but also of phantom limb pain. A 58-year-old man was diagnosed with type 2 diabetes 44 years after having undergone left below knee amputation for congenital AV malformation, at the age of 13. Eight months before the diagnosis of diabetes he began to complain of pain in the leg on the amputated side-pain very similar to that described in typical diabetic neuropathy. This was followed by similar pain in the right leg. MR scan of the spine revealed a small syringohydromyelia of the thoracic cord in addition to a prolapse of disc at L-5/S-1 level on the left side, which was first noted 5 years previously. There were no other features of S-1 compression. The typical neuropathic character of the pain involving both the amputated and the intact limbs that developed with the diagnosis of type 2 diabetes suggest that the neuropathic pain may originate from centres higher than peripheral nerves. (C) 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.