Peripheral neuropathy in chronic venous insufficiency

Chronic venous insufficiency (CVI) of the lower legs may cause tissue damag e, but involvement of peripheral nerves is uncertain. We examined 30 patien ts with CVI and 20 healthy controls using motor and sensory nerve conductio n studies, vibration testing and thermotesting, quantitative sudomotor axon -reflex test, and laser Doppler flowmetry. Subjects with possible confoundi ng factors for peripheral neuropathies were excluded. Prolongation of dista l motor latency of the peroneal nerve (median, 5.4 versus 4.5 ms; P = 0.02) , increased limits for warm (9.60 degrees C versus 5.20 degrees C; P = 0.01 6) and cold detection (3.45 degrees C versus 1.55 degrees C; P = 0.016) and reduced vibration sense (2.8925 versus 1.1075; P < 0.008) were found. The results demonstrate a disturbance of A-alpha fibers, A-beta fibers, A-delta fibers, and thermoafferent-C fibers, possibly induced by ischemia due to v enous microangiopathy and increased endoneurial pressure. Analogous to neur opathic ulcers in diabetes, the CVI-associated neuropathy may also be a cof actor in the development of venous ulcers. (C) 2000 John Wiley & Sons, Inc.