Overview
Burning feet syndrome, also known as Grierson-Gopalan syndrome, is characterized by a sensation of burning pain in the feet without any visible dermatological changes or systemic disease 1.Diagnosis
Neurophysiological Testing: Increased thresholds for thermal and mechanical sensations indicate sensory dysfunction, particularly hypoesthesia and thermal hypofunction 1.
Serum Biomarkers: Elevated serum homocysteine levels may correlate with symptom severity 2.
Neurological Assessments: Specific neurophysiological parameters like P2-L amplitude and V-R latency show potential significance in diagnosis 3.
Psychological Evaluation: Psychological tests can help identify associated psychological factors 3.Management
Vitamin Supplementation: Supplementation with vitamins B12, folic acid, and iron can reduce serum homocysteine levels and alleviate symptoms in patients with deficiencies 2.
Targeted Therapy Based on Deficiencies: Replacement therapy for specific vitamin deficiencies (e.g., B1, B2, B6) may be considered, though efficacy varies 4.
No Evidence for General Vitamin Replacement: For patients without clear deficiencies, vitamin replacement therapy does not show significant benefit 4.Special Populations
Elderly: Increased prevalence and potential for vitamin deficiencies noted; tailored assessments and treatments recommended 24.Key Recommendations
Evaluate Serum Homocysteine Levels in patients with burning feet syndrome to identify potential deficiencies and guide targeted vitamin supplementation (Evidence: Moderate 2).
Conduct Neurophysiological Testing to assess sensory dysfunction, particularly focusing on thermal and mechanical thresholds (Evidence: Moderate 1).
Consider Psychological Evaluation alongside neurological assessments to identify comorbid psychological factors (Evidence: Moderate 3).
Tailor Vitamin Supplementation based on identified deficiencies (e.g., B12, folic acid, iron) rather than universal supplementation (Evidence: Weak 24).References
1 Hartmann A, Seeberger R, Bittner M, Rolke R, Welte-Jzyk C, Daubländer M. Profiling intraoral neuropathic disturbances following lingual nerve injury and in burning mouth syndrome. BMC oral health 2017. link
2 Sun A, Lin HP, Wang YP, Chen HM, Cheng SJ, Chiang CP. Significant reduction of serum homocysteine level and oral symptoms after different vitamin-supplement treatments in patients with burning mouth syndrome. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology 2013. link
3 Mendak-Ziółko M, Konopka T, Bogucki ZA. Evaluation of select neurophysiological, clinical and psychological tests for burning mouth syndrome. Oral surgery, oral medicine, oral pathology and oral radiology 2012. link
4 Hugoson A, Thorstensson B. Vitamin B status and response to replacement therapy in patients with burning mouth syndrome. Acta odontologica Scandinavica 1991. link