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



Khosrawi S¹ ; Haghighat S¹ ; Shayegannia E² Show Affiliations
Source: Journal of Isfahan Medical School Published:2011

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.