[Ischemic neuropathy following surgery for an aortic dissection].

BACKGROUND

Ischemic neuropathy is an uncommon and poorly-understood condition affecting the peripheral nervous system. Most cases involve the upper limbs and occur after vascular surgery.

CASE REPORT: A 42-year-old man developed a multiple mononeuropathy of the lower right limb. The painful, axonal and predominantly sensory neuropathy was caused by ischemia and occurred subsequent to surgery for dissection of the aorta extended to the aortoiliac bifurcation. There was no sign of muscle or skin ischemia. The clinical course was slow and characterised by an incomplete recovery.

DISCUSSION: Ischemic neuropathy of the lower limbs is generally observed after aortoiliac surgery. Occurrence after aortic dissection is exceptional. Most cases show a distal localization and are painful with little motor deficit. They must not be confused with global ischemia of the lower limb or radiculopathy. Early revascularisation is crucial for complete recovery.