Instituut voor Neuropathische Pijn
| Burning feet: trench feet |
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In the old literature you can find pictures like these form patients suffering from allodynia, pain in the soles of the feet by walking. The pain is most intense in the forefeet, that is why these patients walk with a cane and hold their toes in such a way, that the toes do not tough the ground. This is described as trench feet. Although an old term, based on world war number 1, you can still occasionally find patients walking like this, due to the severe burning feet.
This picture is from an old textbook on neurological diseases I found on my bookshelves. The neurological trench feet is very much different from the general trench feet, mostly the term trench foot (also known as fat foot) is used for a medical condition caused by prolonged exposure of the feet to damp, unsanitary and cold condition. At the picture you see the instability of the patient, due to the sensory loss in feet and legs. This creates a state of unbalance, as the brain does not know anymore were the feet are, more or less, and the patient is in need for support, see the hand of the second person on the picture and the cane. This we call sensory ataxia. In this condition the test of Romberg is disturbed. June 2010, Jan M. Keppel Hesselink, MD
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