scholarly journals Comparison of Diabetic Neuropathy Symptom Score and Medial Plantar Sensory Nerve Conduction Studies in Diabetic Patients Showing Normal Routine Nerve Conduction Studies

2008 ◽  
Vol 47 (15) ◽  
pp. 1395-1398 ◽  
Author(s):  
Jae Young An ◽  
Min Su Park ◽  
Joong Seok Kim ◽  
Young Min Shon ◽  
Seung Jae Lee ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Symptom Score ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Diabetic Patients ◽  
Neuropathy Symptom Score

Glycemic Control and Clinico-Electrophysiological Severity of Diabetic Polyneuropathy

2019 ◽  
Vol 5 (2) ◽  
pp. 177-184
Author(s):  
KM Nazmul Islam Joy ◽  
ATM Hasibul Hasan ◽  
Md Rafiqul Islam ◽  
Farhana Kalam ◽  
M Lutful Kabir ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Diabetic Neuropathy ◽  
Nerve Conduction ◽  
Scoring System ◽  
Diabetic Polyneuropathy ◽  
Nerve Conduction Studies ◽  
Clinical Severity ◽  
Diabetic Patients ◽  
Motor Neuropathy ◽  
Clinical Scoring

Background: Diabetic polyneuropathy (DPN) has a significant positive correlation with poor glycemic control (HbA1c ≥7%). The clinical, biochemical and electrophysiological parameters of DPN in Bangladeshi citizens have not yet been explored elaborately Objective: The purpose of the study was to detect and categorize status of glycemic control of Bangladeshi people and to analyze its impact on clinical severity of DPN using Toronto Clinical Scoring System (TCSS) and electrophysiological severity by modified Michigan diabetic neuropathy score (MDNS). Methodology: This observational study was carried out on diabetic patients having probable DPN by purposive sampling, attending Neurology OPD of Dhaka Medical College Hospital, Dhaka, Bangladesh and Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorder (BIRDEM) Hospital, Dhaka, Bangladesh from July 2014 to June 2016. Clinical parameters were recorded and DPN was graded as “no neuropathy”, “mild”, “moderate” and “severe” neuropathy by the Toronto Clinical Scoring System (TCSS). A standard nerve conduction study was performed on each patient and electrophysiological grading according to modified Michigan diabetic neuropathy score (MDNS) was done. Diabetic status of patients was classified into “controlled” (HbA1c <7.0%) and “uncontrolled” (HbA1c ≥7.0%) groups and HbA1c level and the clinical & electrophysiological severity scores were compared and were analyzed. Results: Mean age of the patients was 57.2±9.37 years. 51.0% cases were males and 49% cases were females. The mean HbA1c in the study population was 7.6±0.94% and 56.0% patients had HbA1c≥ 7% .Motor nerve conduction studies revealed that both CMAP amplitudes and MNCV in the ulnar, peroneal and tibial nerves were reduced significantly in patients of uncontrolled (HbA1c≥7%) DM (p<0.001). Sensory nerve conduction studies revealed significant reduction in SNAP amplitudes of median and ulnar sensory and sural nerves in the uncontrolled group (p<0.001). Electrophysiologically, 65.43% patients had mixed sensory-motor neuropathy (p<0.00001). Clinically severe DPN patients were higher (45.2%) within the uncontrolled (HbA1C ≥7%) group (p<0.00001). Similarly, severity in electrophysiological grading was more in patients with uncontrolled DM (48.8%) (p<0.00001). Conclusions: Neuropathic severity, either clinically or electrophysiologically, was associated with higher values of HbA1c. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 177-184

scholarly journals Role of Electro-Diagnostic Tests In Early Detection of Diabetic Neuropathy

1970 ◽  
Vol 24 (1) ◽  
pp. 34-44
Author(s):  
Zahed Ali ◽  
Maliha Hakim ◽  
Monirul Islam ◽  
Nirmalendu Bikash Bhowmik ◽  
Shamsun Nahar ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Action Potential ◽  
Median Nerve ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Diabetic Patients ◽  
Sensory Nerve Action Potential ◽  
Nerve Action ◽  
Sensory Nerve Action

Since the peripheral nerve has the ability to regenerate, therapeutic intervention at earlier stages expected to have a better result in the treatment of diabetic neuropathy. So early detection of diabetic neuropathy is one of the major goals in its management. Purpose: The purpose of present study is to evaluate the efficacy of the electrodiagnostic tests to detect diabetic neuropathy at an early stage (before development of the signs of neuropathy). Method: 30 diabetic patients with or without symptoms of diabetic neuropathy were included in the test group. Diabetic patients with signs of neuropathy and with other complications, like stroke, peripheral vascular diseases were excluded. Twenty six control subjects (non-diabetic with no family history of diabetes) were included. Both the groups were matched for age. To see the functional status of peripheral nerves motor nerve conduction velocity (NCV), compound muscle action potentials (CAMP) of median nerve were studied. Sensory nerve conduction velocities (NCV), and sensory nerve action potential (SNAP) of median and sural nerves were also measured. Results: Sensory nerve conduction velocity of sural nerve was significantly slowed (43.84±8.23 vs 48.23±5.03 m/sec, p < .05) in diabetic patients. Sural sensory nerve action potential has lower in amplitude (13.31±7.03 vs 14.24±4.714 mv, p<.3) in diabetic patients. Median sensory nerve conduction velocity did show difference (50.89+8.23 vs 57.17±6.67 m/s, p < .01) and median sensory nerve action potential has significantly lower in amplitude (3.86±1.016 vs 7.39±4.79, p < .001) in diabetic patients. No significant difference was found in median nerve motor conduction velocity between the two groups of subjects. Amplitude of compound muscle action potential of median nerve also shows no significant variations.Considering mean±SD value of conduction parameter as the cut off value, sural nerve sensory conduction velocity was found slowed in 8 diabetic subjects (26%). Sural nerve sensory action potential was of lower amplitude in 12 diabetic subjects (40%). Eleven diabetic subjects (36%) had lower amplitude for median sensory nerve action potential (SNAP). For compound muscle action potential (CAMP) and sensory nerve action potential (SNAP) half the mean value of control was the cut off point. Conclusion: The result suggests that in diabetic patients of Bangladesh with or without symptoms of neuropathy, abnormalities of nerve conduction parameters can be detected early by routine electrodiagnostic monitoring. Sensory nerve conduction parameters are affected more than motor ones. Amplitude abnormalities are slightly more common than conduction velocity or latency abnormalities for sensory studies. Lower extremity nerves were affected more. Sural median nerve has the highest abnormalities in diabetic patients with early neuropathy. DOI: http://dx.doi.org/10.3329/bjn.v24i1.3038 Bangladesh Journal of Neuroscience 2008; Vol. 24 (1) :34-44

scholarly journals Plasma total homocysteine is not associated with peripheral neuropathy in a groups Bangladeshi type 2 diabetic subjects

2012 ◽  
Vol 11 (4) ◽  
pp. 335-342
Author(s):  
MM Rahman ◽  
Z Hassan ◽  
KB Biswas ◽  
NB Bhowmik ◽  
L Ali
Keyword(s):  
Diabetic Neuropathy ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Plasma Homocysteine ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Conduction Velocities ◽  
Total Homocysteine ◽  
Type 2 Diabetic

Aims: The present study was undertaken to explore the relationship of plasma homocysteine in the pathogenesis of neuropathy in diabetic patients.Subjects and Methods: Forty two type 2 diabetic patients [22 with neuropathy (DN group) and 20 without neuropathy (DNN group)], age range between 35-70 years had relatively controlled glycemia and duration of diabetes 7-15 years, were studied. Motor and sensory nerve conduction velocities and action potential amplitudes of peripheral nerves were determined by following standard protocol. HbA1c was estimated by modified HPLC (BIO-RAD Variant, USA). Serum C-peptide was measured by enzyme linked immunosorbentassay (ELISA), plasma total homocysteine by Fluorescent Polarization Immunoassay (FPIA). Results: Age, BMI and blood pressure of the study subjects were. Duration of diabetes between DN and DNN groups was comparable. DN group had significantly higher fasting glucose levels (9.8±3.8, mmol/l) compared to the DNN group (6.9±1.8, p=0.004). This trend was also reflected in the HbA1c level: 8.7± 2.1 vs 7.2±1.6 in DN group and DNN group respectively (p=0.009). The two diabetic groups had relatively higher absolute C-peptide level compared to the controls (p=ns). DN and DNN groups had significantly higher plasma homocysteine level compared to the Controls. But between the two diabetic groups no significant difference was observed. Ulnar and peroneal motor nerve conduction velocities and compound muscle action potentials in the diabetic neuropathy group significantly lower compared to diabetic counterpart and the controls. Ulnar and sural sensory nerve conduction velocities and action potentials were significantly lower in the diabetic neuropathy group compared to the diabetic counterpart and the controls. Plasma homocysteine did not show any correlation with nerve conduction velocities  and action potential amplitudes.Conclusions: The data concluded that (i) Diabetic neuropathy may not  be related to hyperhomocysteinemia in type 2 diabetic patients of Bangladeshi origin; (ii) Hyperglycemia, even at milder level, is related to neuronal dysfunction in these subjects; and (ii) Hyperinsulinemia don't seem to be prerequisite for neuropathy in these subjects. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12607 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12  

Reproducibility of sensory nerve conduction studies of the sural nerve using ultrasound-guided needle positioning

2011 ◽  
Vol 44 (6) ◽  
pp. 873-876 ◽  
Author(s):  
Olivier Scheidegger ◽  
Alexander F. Küffer ◽  
Christian P. Kamm ◽  
Kai M. Rösler
Keyword(s):  
Nerve Conduction ◽  
Sural Nerve ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Ultrasound Guided

scholarly journals Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands

2009 ◽  
Vol 67 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Dante Guilherme Velasco Hardoim ◽  
Guilherme Bueno de Oliveira ◽  
João Aris Kouyoumdjian
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Compound Action

OBJECTIVE: To compare a long-term carpal tunnel syndrome (CTS) on nerve conduction studies (NCS) in hands treated non-surgically. METHOD: We retrospectively selected 261 symptomatic CTS hands (166 patients), all of them confirmed by NCS. In all cases, at least 2 NCS were performed in an interval greater than 12 months. Cases with associated polyneuropathy were excluded. NCS parameters for CTS electrodiagnosis included a sensory conduction velocity (SCV) <46.6 m/s (wrist to index finger, 14 cm) and distal motor latency (DML) >4.25 ms (wrist to APB, 8 cm). RESULTS: 92.8% were women; mean age was 49 years (20-76); the mean interval between NCS was 47 months (12-150). In the first exam, the median sensory nerve action potential (SNAP) and the compound action muscular potential were absent in 9.8% and 1.9%, respectively. In the second/last exam, SCV worsened in 54.2%, remained unchanged in 11.6% and improved in 34.2%. SNAP amplitude worsened in 57.7%, remained unchanged in 13.1% and improved in 29.2%. DML worsened in 52.9%, remained unchanged in 7.6% and improved in 39.5%. Overall, NCS parameters worsened in 54.9%, improved in 34.3% and remained unchanged in 10.8%. CONCLUSION: Long-term changing in NCS of CTS hands apparently were not related to clinical symptomatology and could lead to some difficulty in clinical correlation and prognosis. Aging, male gender and absent SNAP were more related to NCS worsening, regardless the mean interval time between the NCS.

scholarly journals Combined nerve conduction index in diabetic polyneuropathy

2012 ◽  
Vol 70 (5) ◽  
pp. 330-334 ◽  
Author(s):  
Carlos Otto Heise ◽  
Flavia Costa Nunes Machado ◽  
Simone Consuelo de Amorim ◽  
Sonia Maria de Toledo
Keyword(s):  
Nerve Conduction ◽  
Diabetic Polyneuropathy ◽  
Nerve Conduction Studies ◽  
The Other ◽  
Diabetic Patients ◽  
Lumbosacral Radiculopathy ◽  
Standard Deviations ◽  
Higher Sensitivity

Diabetic polyneuropathy can be confirmed by nerve conduction studies. The data can be analyzed in the form of a combined index instead of individual parameters. METHODS: The combined index included five parameters of nerve conduction studies commonly used for evaluation of polyneuropathies. We evaluated sensitivity in 100 diabetic patients with suspected polyneuropathy, and specificity in 200 non-diabetic patients with suspected lumbosacral radiculopathy. All results were expressed in number of standard deviations (SD). RESULTS: The sensitivity of the combined index was 81 or 74%, and specificity was 97 or 98%, using respectively -2.0 or -2.5 SD as cutoff. The range of sensitivity of the other parameters was 57-65% or 48-56%, and specificity range was 96-98% or 98-100%, using the same criteria. DISCUSSION: The combined index had higher sensitivity and equivalent specificity compared to isolated parameters.

Nerve conduction studies in diabetic neuropathy

Neurology ◽  
1995 ◽  
Vol 45 (4) ◽  
pp. 849-850 ◽  
Author(s):  
F. O. Walker ◽  
V. Chaudhry ◽  
A. M. Corse ◽  
M. L. Freimer ◽  
J. D. Glass ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Nerve Conduction ◽  
Nerve Conduction Studies

Outcome of Carpal Tunnel Release in Diabetic Patients

1994 ◽  
Vol 19 (5) ◽  
pp. 626-629 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
R. T. MANKTELOW ◽  
C. V. A. BOWEN
Keyword(s):  
Retrospective Study ◽  
Peripheral Neuropathy ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Complete Resolution ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Diabetic Patients ◽  
Hand Symptoms

A retrospective study of 15 diabetic patients (20 hands), who underwent carpal tunnel release, was performed to determine the outcome. All patients had a minimum of 18 months of follow-up. Outcome was considered excellent if there was complete resolution of symptoms and this occurred in 35% of the treated hands. Eight hands (40%) had a good outcome with significant improvement of pre-operative symptoms. Outcome was considered poor when symptoms were minimally improved, unchanged, or worse after surgery and this occurred in 25% of treated hands. All hands with a poor final result had either no electrodiagnostic evidence of localized compression or only mild compression in pre-operative nerve conduction studies. It was postulated that the contribution of localized compression to pre-operative hand symptoms was less than the contribution of peripheral neuropathy in these hands.

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