A Study on the Utility of Nerve Conduction Studies in the Diagnosis of Subclinical Diabetic Peripheral Neuropathy (original) (raw)
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Clinical and nerve conduction study correlation in patients of diabetic neuropathy
The Journal of the Association of Physicians of India, 2014
- To study types of neuropathy in Type 2 diabetes. 2) To correlate clinical features of peripheral neuropathy with nerve conduction study in Type 2 diabetes. A total of 50 diabetics, whose onset of diabetes after the age of 30 years were studied from Dr. D. Y. Patil hospital and research centre. Type 2 Diabetes mellitus with symptom suggestive of peripheral neuropathy were studied and included. Chronic alcoholic, peripheral neuropathy due to any other known cause were excluded. METHOD OF COLLECTION OF DATA: History of symptoms like paraesthesia like tingling sensation, burning feet, hyperaesthesia, foot ulcer, history of weakness and gait abnormality was noted. Complete central nervous system examination was performed to look for signs such as diminished ankle jerk, diminished power. Sensory examination for loss of light touch, superficial pain, temperature sense, vibration and joint position was done. Nerve conduction studies were performed using Clarity Octopus NCV/EMG machine. W...
Background: Diabetes Mellitus(DM) a metabolic disorder is the most common cause of peripheral neuropathy. Nerve conduction studies(NCS) are commonly employed to detect the neuropathy. The present study was undertaken to find out the utility of NCS as an early indicator of neuropathy in diabetic patients. Materials & methods: Study was carried out in 50 diagnosed DM patients attending OPD in Medicine, Civil Hospital, Ahmedabad. Diabetic subjects were selected having FBS >110 mg/dL with duration of DM > 5 years. Their HbA1c levels were measured for glycaemic control. Diabetic patients with good glycaemic control were grouped in group A & that with poor glycaemic control in group B. 25 age matched non-diabetic & healthy subjects were selected for control group C. NCS was performed at Institute of Spine, Civil Hospital Campus, Ahmedabad. Nerve conduction parameters like compound muscle action potential(CMAP), sensory nerve action potential(SNAP), nerve conduction velocity(NCV) & distal latency(DL) were studied. Results: In our study there is increase in DL of peroneal, sural; median & ulnar sensory nerves in group B subjects. NCV of sensorimotor nerves is significantly decreased in group B subjects. SNAP of all nerves is reduced in group A & B. CMAP is reduced significantly in all nerves in group B. Conclusion: As DM progress further, it increases risk of neuronal involvement which can be accelerated by poor glycaemic control. Our result indicates demyelinating type of neuropathy with some changes of axonopathy. Therefore NCS is done for early detection of neuropathy in DM patients.
Asian Journal of Pharmaceutical and Clinical Research
Objectives: Peripheral neuropathy is the one of the frequently encountered complication of type 2 diabetes mellitus (T2DM). Although, the prevalence of diabetic peripheral neuropathy is associated with the diabetes duration, in some cases, the state of neuropathy is evident at the time of diagnosis. In this backdrop, the present study was carried out to evaluate the nerve conduction abnormalities in newly diagnosed T2DM. Methods: This was a prospective study carried out on 30 newly diagnosed T2DM within a time range of 1 month. The patient symptoms such as weakness, burning and tingling senzation, hyperesthesia, and foot ulcer and gait abnormalities were recorded. Nerve conduction analysis of upper limb and lower limb of non-dominant hand side was done using neuro pack S1 machine. Results: Thirty newly diagnosed T2DM patients were enrolled in the present study. The mean age of the patients was found to be 58.12±15.28 years. Distal motor latencies were elevated in T2DM patients as co...
International Journal of Advances in Medicine
Background: Diabetes mellitus is known for its complications such as retinopathy, neuropathy and nephropathy. Diabetic neuropathy is one of the devastating complication associated with diabetes mellitus. The objective of this study was to detect sensory motor neuropathy in type 2 Diabetes mellitus by clinical examination and nerve conduction study and to correlate clinical features of peripheral neuropathy with nerve conduction study in Type 2 Diabetes mellitus.Methods: This study was undertaken to study types of neuropathy in type 2 diabetes and to correlate clinical features of peripheral neuropathy with nerve conduction study in type 2 diabetes mellitus.100 patients with diabetes whose onset of diabetes mellitus after age of 30 years and duration of diabetes 5 years or more visiting SGRDIMSR, Vallah, Amritsar were subjected to nerve conduction study to find out peripheral neuropathy.Results: Eight four percentage patients were found to have neuropathy on NCS whereas only 61% of p...
Journal of Diabetes & Metabolic Disorders, 2021
Diabetes mellitus is amongst the most common causes of polyneuropathy worldwide that can eventually terminate to irreversible complications. The remarkable impact of diabetic polyneuropathy as a debilitating condition on the healthcare system and total costs of diabetes care is undeniable. Despite the existence of numerous diagnostic tools such as routine electrophysiologic procedures, its early detection is challenging. This study designed to compare more distal techniques of electrodiagnostic testing, including interdigital sensory nerve conduction studies (NCSs), with conventional approaches and to investigate its role in confirming the early stages of polyneuropathy. This cross-sectional study was performed in the Physical Medicine and Rehabilitation Department of Hazrat Fatemeh Reconstruction Surgery Hospital. Thirty one symptomatic diabetic outpatients and 23 asymptomatic nondiabetic subjects included in our study. We performed nerve conduction studies on five sensory nerves c...
Background: Diabetes Mellitus is one among the diseases that affects peripheral nervous system and symptomatic neuropathy in uncontrolled Diabetes is one of the commonest incapacitating complications. Electro diagnostic tests can be used to detect Diabetic Neuropathy at an early stage (before development of the signs or symptoms of Neuropathy). Nerve Conduction Study (NCS) is considered to be the most sensitive, reliable, non-invasive and objective means of investigations of Diabetic Polyneuropathy. Diabetic Neuropathy is curable, and hence if detected, the proper treatment can be instituted in early stages, which again, can give rise to good outcome. As the peripheral nerve has the ability to regenerate, line of treatment can be planned. Aims & Objectives: To compare and analyze the peripheral nerve conduction studies in symptomatic diabetic neuropathy cases with age and sex matched normal subjects emphasizing on use of Nerve conduction studies as a diagnostic approach to prevent Severe Neuropathy. Methods: The study group consists of 30 cases diagnosed with Diabetic neuropathy referred to our neurophysiology lab and control group consists of 30 age and sex matched normal subjects who are non diabetic, healthy volunteers. Statistical analysis was done using unpaired t-test and 28 out of 30 cases considered for statistical analysis. Motor and Sensory nerve conduction studies conducted in both Median nerves using bipolar surface electrodes with RMS EMG EP MARK-II machine. Results: There is a definite decrease in amplitude and nerve conduction velocities of both the sensory and motor components, axonal and demyelinating type significantly correlating with higher HBA1c levels and duration of diabetes. F minimum latencies were increased possibly more of demyelinating type of Polyneuropathy. Conclusion: NCS being a simple, harmless, non-invasive and objective technique along with easy interpretation of results can be used routinely to evaluate the status of nerves in patients with Type 2 Diabetes Mellitus to prevent more disabling state at the earliest.
Pakistan Armed Forces Medical Journal
Objective: To compare the detection of diabetic neuropathy by clinical assessment and nerve conduction study in type 2 diabetes mellitus patients. Study Design: Prospective comparative study. Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital Rawalpindi Pakistan, Jan 2020 to May 2021. Methodology: A total of 300 patients having type 2 diabetes mellitus for more than ten years were included in the study. Revised neuropathy disability score was calculated by the consultant medical specialist on all the patients to make a clinical diagnosis of neuropathy. Nerve conduction studies were performed in the Department of Neurology. Findings of both methods to diagnose the patterns of diabetic neuropathy were compared. Results: Out of 300 patients suffering from type 2 diabetes mellitus, 188 (62.7%) were males, while 112 (37.3%) were females. The mean age of the study participants was 53.33±4.55 years, and the mean duration of diabetes mellitus was 11.22±5.71 ...
Abnormal Nerve Conduction Parameters in Young Diabetic Patients at Diagnosis
BIRDEM Medical Journal, 2016
Background and Objectives: Diabetes in the young patients, less than 30 years of age, usually has sudden onset and severe hyperglycemia who are resistant to ketosis. Taking the advantage of this uniqueness of this group of patients the present study was aimed to evaluate their peripheral nerve functional status, explore its relationship with glycemic status and find out utility of nerve conduction study for detection of neuropathy at diagnosis to introduce timely intervention in the necessary cases. Materials and Methods: A total number of 32 newly diagnosed untreated diabetic patients, age 30 years or less, consecutively attending the BIRDEM Outpatient department were recruited. Age-matched healthy subjects (n=30) with no family history of diabetes served as controls. Motor and sensory conduction velocities (NCV), distal latencies (DL), compound muscle and sensory nerve action potentials (CAMP, SNAP) of ulnar, peroneal and sural nerves were studied following standard protocol. Glucose was determined by glucose-oxidase, Fructosamine by enzymatic colorimetric method. Results: Ulnar motor NCV (m/sec, mean±SD) was significantly slower in diabetic group compared to the controls [58.29±6.88 vs 66.56±6.13; p<0.001]. CAMP [(µv, median] of ulnar nerve was significantly lower in diabetic patients [4.5 vs 5.8; p<0.05]. Motor nerve conduction velocity of peroneal nerve was significantly slower (p<0.0001) in diabetic patients. Peroneal nerve CMAP [µv, median] amplitude showed similar trends [5.5 vs 8.7 p<0.001]. Sural sensory NCV was significantly slower [35.22±14.04 vs 42.38±8.52; p<0.05] in diabetic patients. Peroneal nerve conduction velocity showed significant negative correlation with fasting glucose (r=-0.456, p<0.001). Peroneal motor distal latency showed positive correlation with serum fructosamine value [r=0.439, p<0.05]. Peroneal and ulnar NCV was negatively correlated [p<0.001 and p<0.05 respectively] with fructosamine. Sural sensory nerve action potential was also negatively correlated [r=-0.400 p<0.05]. S. Fructosamine was negatively correlated with sensory ulnar nerve action potential. Conclusion: The result suggest that in the newly diagnosed untreated young diabetics of Bangladesh, abnormalities of nerve conduction parameters are detected early by doing nerve conduction study; motor nerve conduction parameters are affected more than sensory ones. Abnormal nerve conduction parameters seem to be related to degree of hyperglycaemia in early neuropathic patients.
Muscle & Nerve, 1993
One hundred one normal subjects and 46 patients were investigated. Various objective and subjective tests for polyneuropathies were compared. Motor and sensory nerve conduction velocities are the most sensitive tests. In normals, age hardly influenced nerve conduction velocities. This is believed to be a result of the strict exclusion criteria. Diagnostic sensitivity is also high with the vibration fork test and with vibratometry at the big toe. Results with the method of limits are as reliable and sensitive as more cumbersome techniques, such as the titration method and the forced choice method. Thermal thresholds and cardiovascular tests are less sensitive. The most correct overall classification is attained with a combination of tests reflecting the function of different nerve fiber classes in the peripheral and autonomic nervous systems.
Journal of Iranian medical council, 2022
Background: Some clinical scoring systems as the quantitative tools have been developed to assess the presence and severity of Diabetic Peripheral Neuropathy (DPN) based on both the patient's complaints and the physicians' findings. This study was aimed at assessing the presence and severity of sural and peroneal nerve neuropathies using Michigan Neuropathy Screening Instrument (MNSI) and United Kingdom Screening Test (UKST) questionnaire compared with electrodiagnosis assessments. Methods: 148 patients with Diabetes Mellitus (DM) including 80 females and 68 males with a mean age of 57.6, 19 type 1DM and 129 type 2 DM were recruited in this study. The findings of the electrophysiological study such as peroneal and sural nerves' conduction delay, velocity and amplitude were gathered. The patients were also assessed regarding the clinical neuropathy status using the two instruments of MNSI and UK. Results: The mean neuropathy score of MNSI and UKST were 2.2 (1.7) and 4.1 (3.0), respectively. Each instrument detected the DPN in 47.3% and 64.9% of the patients, respectively. Also, based on the nerve conduction studies (NCS), the neuropathy of sural and peroneal nerves was found in 54.1% and 79.7%, respectively. Unlike the peroneal nerve, there was a significant agreement between the electrodiagnosis assessment and the screening tools in the diagnosis of sural nerve neuropathy. Conclusion: Given that NCS is a practical, simple, and non-invasive approach and also can determine the level of damage and regeneration in peripheral nerves, sural nerve conduction study is suggested as a convenient option for screening and diagnosing the diabetic neuropathy.