مقايسه معيارهاي ارزيابي باليني با يافته هاي نوروفيزيولوژيك عصب سورال در تشخيص نوروپاتي بيماران مبتلا به ديابت

COMPARISON OF CLINICAL CRITERIA WITH NEUROPHYSIOLOGIC FINDINGS OF SURAL NERVE IN DIAGNOSIS OF DIABETIC PERIPHERAL NEUROPATHY

Background: Diabetic Neuropathy is the most common and troublesome complication of Diabetes Mellitus, leading to the greatest morbidity and mortality and resulting in a huge economic burden for diabetes care. Early diagnosis of distal symmetric sensorimotor polyneuropathy, a common complication of diabetes, may decrease morbidity by allowing potential therapeutic interventions. Methods: In 68 diabetic patients after neuropathy screening by U.K and Michigan scores. Bilateral sural nerve conduction parameters as nerve conduction velocity, latency and amplitude were determined and analysed. Results: 54.4% of patients had Rt sural abnormal response, 50% had abnormality in left side and 39.7% had bilateral abnormality. There was significant statistical correlation between Michigan physical score and electrophysiologic finding (P-value < 0.003) but no correlation with U.K score (P-value > 0.3). The most prevalent abnormal electrophysiologic finding was amplitude decrement of sural response. Conclusion: Sural nerve response is one of the simplest and most sensitive peripheral sensory nerves for electrophysiologic study of diabetic neuropathy and its evaluation is recommended in all diabetic patients in spite of normal physical examination and history for detection of subclinical neuropathic cases. For increment of sensitivity, amplitude measurement of sensory response is highly recommended.