Could Mr. C’s foot numbness be related to his stoke?
What other causes could there be for this pattern of
numbness? There is the possibility that Mr. C’s foot
numbness could be related to his stroke; however, this
numbness is most likely related to diabetic neuropathy
given his past health history. Neuropathic pain is the
result of trauma or disease of nerves and leads to
abnormal processing of sensory information by the
peripheral and central nervous systems (McCance &
Heuther, 2006). 

Diabetic neuropathy is seen in older diabetic patients
and is a result of micro-vascular injury to the small
blood vessels that supply the nerves of the periphery
(i.e. hands and feet) (McCance & Heuther, 2006; Up to
Date, 2008). Diabetic neuropathy is primarily a
symmetrical sensory neuropathy, initially affecting the
distal lower extremities (Up to Date), as evidenced by
Mr. C. In addition, Mrs. C has stated that her husband’s
“sugars” have been “out of control” which indicates the
potential for increased micro- vascular damage and
development of neuropathies. 

A less likely cause of Mr. C’s neuropathy includes
previous chemotherapy treatment, especially with vinca
alkaloid drugs. This chemotherapy regime may be
associated with a variety of neuropathies producing
painful sensations in the hands and feet (McCance &
Heubert, 2006).

References   McCance, K. L., & Heuther, S. E. (2006).
Pathophysiology: The biological basis for disease in
adults and children. Elsivier Mosby: Philadelphia.

Up to Date. (2008). Seizure disorders. Retrieved from
www.uptodate.com. May 26, 2008.