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Grierson-Gopalan Syndrome


Grierson-Gopalan syndrome (better known as burning feet syndrome). Consists of severe burning and aching of the feet, hyperaesthesia, pain, elevated skin temperature, and vasomotor changes of the feet, associated with excessive sweating and general body wasting. Ocular complications may include scotoma and amblyopia. Prevalent in women; onset between 20 and 40 years of age.

This can occur due to Hereditary factors or Mechanical factors such as mechanical compression of the peripheral nerves (as seen in tarsal tunnel syndrome) and in diseases such as hypothyroidism, diabetes and rheumatoid arthritis.
Studies have also related this condition to

  • Psychosomatic causes
  • Vitamin B deficiency
  • Renal failure (dialysis patients)
  • Hypothyroidism

Burning feet syndrome may occur as a result of mechanical compression of the peripheral nerves (as seen in tarsal tunnel syndrome) and in diseases such as hypothyroidism, diabetes and rheumatoid arthritis. Nerve entrapment can occur at the level of the tarsal tunnel adjacent to the medial malleolus. Nerve entrapment due to sciatic mononeuropathy and spinal arteriovenous malformation can also cause burning feet.

Burning is usually limited to the soles of the feet but may ascend to involve the top of the ankles or lower legs. The arms and palms of the hands are spared. A few patients occasionally complain of pins and needles or tingling in the lower extremities. Symptoms show worsening at night with day time improvement. Patients with underlying psychiatric disorders may present with a myriad of psychosomatic.

signs and symptoms in association with burning feet. On examination, there is a paucity of objective signs. The overlying skin and blood vessels are normal in most, while in some patients there may be accompanying erythema of the feet with warm overlying skin as in erythromelalgia. There is no local tenderness over the affected parts.

If the condition is being caused by a disease i.e. Diabetes, Hyperthyroidism, Psychosomatic, etc than disease specific measures must be taken.

General treatment consists of wearing open and comfortable shoes, especially those with arch supports, and wearing cotton socks is helpful. Soaking the feet in cold water (not ice cold) for around 15 minutes can bring symptomatic temporary relief. Avoidance of feet exposure to heat should be advised. Certain creams and vitamin B supplements can help reduce burning feet.

In mechanical cases such as tarsal tunnel syndrome, conservative treatment with arch supports and wider shoes may successfully relieve discomfort. If burning feet is due to flat feet, orthotics may help restore the foots arch.

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