SENSORY AXONOPATHY IN MILD-TO-MODERATE PERIPHERAL ARTERIAL-DISEASE

The effect of mild to moderate arterial occlusive disease on periphera l nervous system conduction was prospectively investigated in 18 subje cts and 18 control subjects, aged 40 to 85 years. Experimental and con trol subjects underwent a thorough history and physical followed by va scular and electrophysiologic studies. The primary outcome measure was the sensory nerve action potential. Although 33% of the subjects with peripheral arterial disease had experienced paresthesias, the clinica l evaluation of sensation was relatively unaffected. Sensory conductio n studies revealed 30% absent sural responses and 56% absent superfici al peroneal nerve responses in subjects with peripheral arterial disea se compared with 3 and 14% absent responses in control subjects, respe ctively (P = 0.044; 0.025). There were no differences in distal latenc y or sensory amplitude, although the superficial peroneal amplitude di d approach significance (P = 0.06). No significant differences were fo und in motor distal latency, amplitude, or conduction velocity. Age, l eg length, temperature, disease severity, presence of paresthesias, ch olesterol levels, and past alcohol or tobacco ingestion did not accoun t for the difference in sensory responses. These results support the p resence of a mild sensory axonopathy in subjects with peripheral arter ial disease. Electromyographers should be cognizant of absent distal r esponses from peripheral arterial disease so as not to ascribe the fin dings to an alternative pathology and should not attribute abnormal mo tor conduction results to the presence of this degree of peripheral ar terial disease.