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Journal of the Korean Academy of Rehabilitation Medicine 2002;26(2):146-151.
Comparison of Sural Nerve Amplitude and Sural/Radial Amplitude Ratio in the Electrodiagnosis of Diabetic Neuropathy.
Lee, Hang Jae , Hwang, Mi Ryoung , Kim, Dong Hwee , Kwon, Hee Kyu
Department of Rehabilitation Medicine, Korea University College of Medicine, Korea. mocean70@hanmail.net
당뇨병성 신경병증에서 비복신경의 진폭과 비복/천요골 진폭비의 비교
이항재, 황미령, 김동휘, 권희규
고려대학교 의과대학 재활의학교실
Abstract

Objective
To evaluate the usefulness of the sural/superficial radial sensory nerve action potential amplitude ratio (SRAR) in the electrodiagnosis of diabetic polyneuropathy.


Method
Nerve conduction study was performed in 80 diabetic patients and 31 normal adults. Standard nerve conduction studies were performed. Sural nerve response was recorded with the active electrode on the posterosuperior margin of the lateral malleolus and stimulation 14 cm proximally. Superficial radial nerve response was recorded with the active on the snuffbox and stimulation 10 cm proximally. Baseline-to-peak sensory nerve action potential (SNAP) amplitudes were measured, and SRAR were obtained. The diabetic group was subdivided into an electrophysiologically normal group (DMNL, n=32) and neuro-

pathy group (DMPN, n=48). SRAR was compared among the control (NORM, n=31), DMNL and DMPN groups.


Results
SRAR was 0.344 in NORM, 0.314 in DMNL and 0.145 in DMPN, respectively. SRAR showed 77.1% sensitivity and 93.8% specificity. Sural SNAP amplitude sensitivity was 85.4% and specificity, 88.7%.


Conclusion
The relatively high specificity of SRAR indicates its usefulness in the diagnosis of diabetic polyneuropathy. However, as the superficial radial sensory SNAP amplitude decreased significantly in the diabetic groups compared to control, the SRAR is not superior to the sural SNAP amplitude in the diagnosis of diabetic polyneuropathy. (J Korean Acad Rehab Med 2002; 26: 147-151)

Key Words: Superficial radial, Sural, Superficial radial, Amplitude ratio, Diabetic polyneuropathy


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