ROLE OF MEDIAL AND LATERAL PLANTAR SENSORY NERVE CONDUCTION STUDIES IN EARLY DETECTION OF DIABETIC NEUROPATHY

Abstract

Introduction:Diabetic neuropathy causes a wide spectrum of abnormalities from autonomic and cardiovascular dysfunction to diabetic foot with a prevalence of 10% in newly diagnosed diabetes, stressing the importance of early diagnosis. This study evaluates the utility of SNAPS of plantar nerves in patients with normal NCS for early detection of diabetic neuropathy.

Purpose of study: Evaluate the routine NCS and medial and lateral plantar nerve NCS in symptomatic diabetic patients and controls. To assess if medial and lateral plantar nerve NCS increases the sensitivity in detection of neuropathy in diabetic patients

Materials and Methods: 100 subjects were included in the study consisting of 50 (28 Male & 22 Female) Diabetic patients and 50 (25 Male & 25 Female) control group. NCS was performed for the evaluation of plantar nerves along with routine motor and sensory nerves on them, recruited from December 2017 to March 2018 in the Department of Neurology, SRIHER, Chennai.

Results: Among the 50 patients with Diabetes, we investigated 10 individuals each aged 31-40 years (mean 35.2±3.22), 41-50years (45.6±3.34), 51-60years (56.3±4.57), 61-70years (66.2±3.42) and 71-80 years (75.1±3.28) with the duration of diabetes for >25 years (29.3±3.46). 17 patients (34%) had normal NCS with prolonged SNAPS of plantar nerves, 23 patients (46%) had both. Abnormal NCS in Diabetes showed statistically significant prolongation of latency and reduction in amplitude and drop out in conduction velocity in all age groups and also as the duration of diabetes increased.

Conclusion: It may be possible to detect the neuropathy early in neurophysiological manner in diabetic PNPs by studying plantar sensory nerve conduction properties in addition to the nerve conduction parameters studied in a standard PNP protocol.

Keywords: Diabetic peripheral neuropathy, Medial and lateral plantar nerves, NCS