Sensory and Motor Peripheral Nerve Findings in Diabetic Patients Referred for Electrodiagnosis

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Resident, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Resident, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Diabetes mellitus is the most prevalent endocrine disease and the most common cause of peripheral neuropathy which is one of the important late complications of diabetes. Careful neurologic examination and electrodiagnosis are essential and valuable in early diagnosis of neuropathy and prevention of its sequence. The aim of this study was to assessment the electroneurographic findings in diabetic patients.Methods: In this study 103 random selected diabetic patients who referred for electroneurographic studies were evaluated. Neurologic and electroneurographic examination were done in all patients. Three motor nerves (M-median, deep peroneal and tibial) and three sensory nerves (S-median, sural and superficial peroneal) were evaluated and in each nerve its conduction velocity, distal latency and amplitude and also bilateral H-reflex from soleus muscle were measured.Finding: Among 103 studied subjects, 30 patients (29.1%) had type I and 73 (70.9%) had type II diabetes mellitus. Overall incidence of diabetic neuropathy was 79.6%. There is direct correlation between duration of diabetes and prevalence of diabetic neuropathy. The most common complaint was numbness and tingling of distal part in 72% (P < 0.0001).The most common physical finding was abnormal ankle jerk in 94% (P < 0.001). The most sensitive finding in electroneurographic examination was absent or prolonged H-reflex in 92.5% (P < 0.0001). Overall, the parameter of amplitude was more sensitive than distal latency.Conclusion: Nerve conduction parameters especially H-reflex study and amplitude of sensory responses are valuable in early diagnosis of diabetic neuropathy. There is good correlation between clinical and electroneurographic findings, thus thorough clinical examination is highly recommended, to prevent unnecessary work ups and help preventing untoward complications. 

Keywords

References

  1. Zdravkovic V, Daneman D, Hamilton J. Presen-tation and course of Type 2 diabetes in youth in a large multi-ethnic city. Diabet Med 2004; 21(10): 1144-8.
  2. Otieno CF, Kayima JK, Omonge EO, Oyoo GO. Diabetic ketoacidosis: risk factors, mechanisms and management strategies in sub-Saharan Afri-ca: a review. East Afr Med J 2005; 82(12 Suppl): S197-S203.
  3. Congdon P. Estimating diabetes prevalence by small area in England. J Public Health (Oxf) 2006; 28(1): 71-81.
  4. Lin SF, Lin JD, Huang YY. Diabetic ketoacido-sis: comparisons of patient characteristics, clini-cal presentations and outcomes today and 20 years ago. Chang Gung Med J 2005; 28(1): 24-30.
  5. Rowland LP, Pedley TA. Merritt's neurology. 12th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.
  6. Dumitru D. Nerve Conduction Studies. In: Du-mitru D, Amato AA, Zwarts MJ, Editors. Elec-trodiagnostic Medicine. Philadelphia: Hanley & Belfus; 2002. p. 194-217.
  7. Behse F, Buchthal F, Carlsen F. Nerve biopsy and conduction studies in diabetic neuropathy. J Neurol Neurosurg Psychiatry 1977; 40(11): 1072-82.
  8. Fleisher LA, Breslow MJ. Prevalence of Diabetic neuropathy in adolescents. Arch Pediatr Adolesc 2003; 277: 1127-234.
  9. Jazayeri M, Ranjbaran Z. Nerve conduction studies in 40 patients with diabetic neuropathy. [Thesis]. Shiraz: Shiraz University of Medical Sciences; 2004.
  10. DeLisa JA, Gans BM, Bockenek WL, Frontera WR, Gerber LH, Gerber LH, et al. Physical Medi-cine and Rehabilitation Principles and Practice. 4th ed. Philadelphia: Lippincott Williams & Wil-kins; 2004.
  11. Ropper AH, Brown RH. Adams and Victor's Principles of Neurology. 8th ed. New York: McGraw-Hill Professional; 2005.
  12. Marker E, Goll V. Proceeding of a consensus development conference on standardized measures in diabetic neuropathy. Neurology 2002; 42: 1823-39.
  13. Pease WS, Lew HL, Johnson EW, Editors. John-son's Practical Electromyography. 4th ed. Phila-delphia: Lippincott Williams & Wilkins; 2006.
Journal of Isfahan Medical School
Volume 29, Issue 129 - Serial Number 129
January and February 2011
Pages 165-171

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History

  • Receive Date: 24 February 2011
  • Revise Date:
  • Accept Date: 06 April 2022

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