Usefulness of Questionnaires, Physical Examination and Median Mixed Nerve Conduction Studies in Patients with Diabetes Mellitus. |
Jeong, Sang Wook , Park, Hee Seok , Jeong, Ho Joong , Kim, Ghi Chan , Park, Yo Han |
1Department of Rehabilitation Medicine, Kosin Medical College, Pusan, Korea. 2Department of Internal Medicine, Kosin Medical College, Pusan, Korea. |
당뇨병성 신경증에서 문진표, 이학적 검사 및 혼합신경 전도검사의 유용성 |
정상욱, 박희석, 정호중, 김기찬, 박요한1 |
고신대학교 의학부 재활의학과교실 및 1내과학교실 |
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Abstract |
Objective To find simple screening method for assessment of patients with diabetic neuropathy by use of brief questionnaire, scored physical examination including vibration perception threshold, and mixed median conduction study. Method Subjects were 24 patients with diabetes mellitus. Conventional nerve conduction study was performed in 24 patients and the patients were divided into two groups: 11 patients with polyneuropathy; 13 patients of normal findings. The questionnaires were given for evaluation of sensory function in all the subjects. The questionnaires were followed by physical examination including two point discrimination, vibration perception threshold by using biothesiometer, 10 gram filament test, pin prick test, DTR check, and muscle strength test. Abnormality was determined by the number of positive responses or abnormal clinical findings. Finally, we recorded the conduction velocity and amplitude of median mixed nerve and compared these parameters to values of 20 normal adults. Results The questionnaire and physical exam scores were higher in patients with polyneuropathy (p<0.01). The patients with polyneuropathy showed higher vibration perception threshold values (p<0.01) and slower conduction velocity and smaller amplitude of median mixed nerve (p<0.05). In correlation with conventional nerve conduction study, the median mixed nerve conduction velocity had higher kappa value than amplitude in screening for diabetic polyneuropathy. Conclusion We suggest the questionnaires, scored physical examination, vibration perception threshold, and median mixed nerve conduction velocity to be a simple screening method for assessment of patients with diabetic plyneuropathy. |
Key Words:
Diabetic polyneuropathy, Questionnaires, Scored physical examination, Vibration perception threshold, Median mixed nerve conduction velocity |
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