An aid to the electrophysiological diagnosis of diabetic peripheral neuropathy

• Published in: Neurophysiologie clinique Vol. 19; no. 4; p. 327
• Main Authors: Doucet, J, Senant, J, Menard, J F, Samson-Dollfus, D, Schrub, J C
• Format: Journal Article
• Language: French
• Published: France 01.08.1989
• Subjects: Adult; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - physiopathology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Diabetic Neuropathies - diagnosis; Diabetic Neuropathies - physiopathology; Electromyography; Female; H-Reflex; Humans; Male; Median Nerve - physiopathology; Middle Aged; Neural Conduction; Peroneal Nerve - physiopathology; Sural Nerve - physiopathology
• ISSN: 0987-7053

The electrophysiological diagnosis of peripheral neuropathy in diabetics becomes increasingly difficult with the increase in number of parameters measured. We have examined 102 subjects: 60 diabetics, 32 control subjects and 10 with impaired glucose tolerance. From the 37 recorded parameters during 8 examinations, a linear discriminant analysis allowed us to separate the 19 diabetics with clinical neuropathy and the control subjects with only 5 parameters, with a good concordance (96%): the motor conduction velocities (MCV) of the peroneal and median nerves, the amplitude of the action potential (AP) of the sural nerve, the Hmax/Mmax ratio and the M latency of the Hoffman reflex. These parameters, weighted with a coefficient, constitute a score of discrimination. This score has been tested by the Jackknife method on the same sample (94% of well-classified patients), then validated on the other patients. Thus we propose a method to aid the diagnosis of diabetic peripheral neuropathy, without the arbitrary character of the classical single parameter method, and allowing easy repetition.