Role of Electro-Diagnostic Tests In Early Detection of Diabetic Neuropathy (original) (raw)
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The sensitivity of clinical diagnostic methods in the diagnosis of diabetic neuropathy
The Journal of international medical research
This study assessed the sensitivity of various methods for the clinical diagnosis of diabetic peripheral neuropathy. A total of 147 randomly selected patients with diabetes mellitus and 65 age- and sex-matched healthy controls were evaluated by various clinical (the neuropathy symptom score [NSS], the neuropathy disability score [NDS], vibration perception thresholds [VPTs], Tinel's sign and Phalen's sign), laboratory (fasting plasma glucose and glycosylated haemoglobin levels) and electro-physiological (nerve conduction studies, H-reflex and F-wave measurements) methods. In the patient group, 8.2% had an abnormal NSS, 28.5% had a positive Phalen's sign, 32.6% had a positive Tinel's sign, 42.8% had an abnormal VPT and 57.1% had an abnormal NDS. Significant correlations were found between electro-physiologically confirmed neuropathy and the two provocation tests and abnormal VPTs. In conclusion, assessment with a complete neurological examination and standard electrop...
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, 2015
Background: Almost half of Diabetic Peripheral Neuropathies (DPNs) are symptom-free. Methods including questionnaires and electrodiagnosis (EDx) can be fruitful for easy reach to early diagnosis, correct treatments of diabetic neuropathy, and so decline of complications for instance diabetic foot ulcer and prevention of high costs. The goal of our study was to compare effectiveness of the Michigan neuropathy screening instrument (MNSI), United Kingdom screening test (UKST) and electrophysiological evaluation in confirming diabetic peripheral neuropathy. Methods: One hundred twenty five known diabetes mellitus male and female subjects older than 18 with or without symptoms of neuropathy comprised in this research. All of them were interviewed in terms of demographic data, lipid profile, HbA1C, duration of disease, and history of retinopathy, so examined by Michigan neuropathy screening instrument (MNSI), United Kingdom screening test (UKST), and nerve conduction studies (NCS). The collected data were analyzed by SPSS software 18. Results: One hundred twenty five diabetic patients (70 female, 55 male) were recruited in this study with a mean age of 58.7 ± 10.2, and mean duration of diabetes was 10.17 ± 6.9 years. The mean neuropathy score of MNSI and UKST were 2.3 (1.7) and 4.16 (2.9), respectively. Each instrument detected the peripheral neuropathy in 78 (69 %) and 91 (73 %) of patients, respectively. There was a significant relationship between number of neuropathies and mean of diabetes duration and development of retinopathy in both questionnaire evaluations and NCS. By nerve conduction study, neuropathy was detected in 121 (97 %) diabetic patients were reported in order 15 (12 %) mononeuropathy (as 33 % sensory and 67 % motor neuropathy) and 106 (85 %) polyneuropathy (as 31 % motor and 69 % sensorimotor neuropathy).
Electrophysiological measurements of diabetic peripheral neuropathy: A systematic review
Diabetes & metabolic syndrome, 2018
Peripheral neuropathy is one of the main complications of diabetes mellitus. One of the features of diabetic nerve damage is abnormality of sensory and motor nerve conduction study. An electrophysiological examination can be reproduced and is also a non-invasive approach in the assessment of peripheral nerve function. Population-based and clinical studies have been conducted to validate the sensitivity of these methods. When the diagnosis was based on clinical electrophysiological examination, abnormalities were observed in all patients. In this research, using a review design, we reviewed the issue of clinical electrophysiological examination of diabetic peripheral neuropathy in articles from 2008 to 2017. For this purpose, PubMed, Scopus and Embase databases of journals were used for searching articles. The researchers indicated that diabetes (both types) is a very disturbing health issue in the modern world and should be given serious attention. Based on conducted studies, it was...
International Journal of Contemporary Medical Research [IJCMR]
Introduction: Peripheral neuropathy is the commonest incapacitating complication of diabetes mellitus. Many of the patients are asymptomatic for neuropathy thus developing diabetic foot and ulceration, ultimately leading to amputation. Study aimed to detect subclinical diabetic peripheral neuropathy in early stages by using nerve conduction studies. Material and methods: Cases consisted of one hundred patients of Type 2 Diabetes Mellitus but asymptomatic for peripheral neuropathy. Twenty-five normal, healthy individuals served as controls. The studies of distal latency, amplitude and conduction velocity of motor fibers of right and left peroneal and tibial nerves were performed. Results: There was a statistically significant decrease in motor nerve conduction velocity and prolongation of distal latency for both peroneal and tibial nerves on either side in cases versus controls. The CMAP (compound muscle action potential) amplitude in right and left peroneal nerves was less in cases as compared to controls, which was statistically significant for left side but not for right side. CMAP amplitude was statistically significantly less in cases versus controls for right tibial nerve, but for left tibial nerve there was a statistically insignificant increase. Data are presented as mean ± SD. Results were evaluated by unpaired t-test. A level of P <0.05 was accepted as statistically significant. Conclusion: Nerve conduction studies (NCS) being simple and non-invasive technique can be used routinely to diagnose diabetic neuropathy in early stages so that proper treatment can be instituted to obtain good outcome.
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 ...
2020
Introduction: Diabetic peripheral neuropathy is the most common long term complications of DM. Nerve conduction studies are the most sensitive indices of the severity of neuropathy. Vitamin D is required for nerve cell growth and cell development, neuronal survival and has important role in regulating nerve axonal regeneration .It can be utilized for prevention and therapy of diabetic neuropathy. Aim: To study the association between Vitamin D levels and Nerve conduction velocity in Type 2 Diabetes Mellitus patients. Methodology: Total number of 60 subjects (diabetic subjects and the healthy controls) were examined to assess the Diabetic neuropathy. Sensory Nerve conduction velocity test was done along with the estimation of Vitamin D levels and HbA1c levels in all the diabetic subjects (HbA1c≥6.5%) and the healthy controls. Results: The analysis showed that the NCV decreased in diabetic patients with a low Vitamin D levels in comparison to healthy subjects with normal Vitamin D lev...
A Review on Detection of Diabetic Peripheral Neuropathy
Diabetic Peripheral Neuropathy (DPN) is a lifelong problem of Diabetes. The nerves that reach to the arms, legs, and feet become damaged due to high glucose level over a long period of time. It leads to loss of sensation, and sometimes pain in feet and hands. DPN increases the risk of foot ulcers and amputation. About 60% to 70% over entire humans with diabetes will ultimately generate Peripheral Neuropathy. The present study proposes different methods for detection of DPN like Touch sensation test, Pressure sensation Test, Vibration sensation test. Currently, DPN diagnosed by using three different instruments. The first is 10 g SWM (Semmes Weinstein Monofilament), second is Tuning fork, third is Biothesiometer. One more method is also used that is Nerve conduction (NC) study, which is time consuming and cost is high. Different methods have some limitation like 10 g SWM have limitations like fabricating fault and atmospheric effect. The second instrument Tuning fork has limitation like method variation means physician to physician result was varied to detect DPN. Last instrument, Biothesiometer is more expensive instrument and required a highly skilled physician. Vibration is a very important parameter to detect DPN. On the basis of vibration mechanism, level of DPN can also be identified. To overcome above limitations, a reliable, portable, easiest and valid tool is required to detect DPN.
Study of clinical and electrophysiology of peripheral neuropathy in diabetes
International Journal of Medical Science and Innovative Research (IJMSIR), 2021
Diabetes has become one of the largest global healthcare problems of the 21 century. According to the Centers for Disease Control and Prevention, the population prevalence of diabetes in the US is approaching 10% and is increasing by 5% each year. Diabetic neuropathy is the most common complication associated with diabetes mellitus. There has been an evolution in our understanding of the pathophysiology and the management of diabetic polyneuropathy over the past decade. The purpose of the current study is to evaluate the degree of correlation of clinical examination with electrophysiology in diabetics with peripheral neuropathy for better management of neuropathy in terms of its early and timely detection. Results ;Most common age group in our study was 70-79 years 26 (27.1%) followed by 25 (26.0%) who belonged to age groups 50-59 and 60-69 years while as 20 (20.8%) belonged to age group < 50 years. The mean age in our study was 59.4 + 11.83.The minimum age was 37 years and maximum age was 79 years. We assessed the sensitivity and specificity of two major scores NSS and NDS . Sensitivity, specificity, NPV, PPV and accuracy of clinical examination of NSS was 83.33, 66.64, 70.58, 80.64, 66.66;and NDS was 93.93, 52.77, 86.36, 77.02, 69.29 respectively. Conclusion; neurological examination is important for screening neuropathy in diabetics .using different scores like NDS and NSS neuropathy can be predicted with high reliability which can help in early detection and timely management. Keywords: Centers for Disease Control and Prevention, Diabetes, Peripheral nerve, pathophysiology, polyneuropathy.
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.