Subclinical Ulnar Neuropathy at the Elbow in Diabetic Patients
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To demonstrate the prevalence and characteristics of subclinical ulnar neuropathy at the elbow in diabetic patients.Methods One hundred and five patients with diabetes mellitus were recruited for the study of ulnar nerve conduction analysis. Clinical and demographic characteristics were assessed. Electrodiagnosis of ulnar neuropathy at the elbow was based on the criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM1 and AANEM2). The inching test of the ulnar motor nerve was additionally performed to localize the lesion.Results The duration of diabetes, the existence of diabetic polyneuropathy (DPN) symptoms, the duration of symptoms, and HbA1C showed significantly larger values in the DPN group (p<0.05). Ulnar neuropathy at the elbow was more common in the DPN group. There was a statistically significant difference in the number of cases that met the three diagnostic criteria between the no DPN group and the DPN group. The most common location for ulnar mononeuropathy at the elbow was the retrocondylar groove.Conclusion Ulnar neuropathy at the elbow is more common in patients with DPN. If the conduction velocities of both the elbow and forearm segments are decreased to less than 50 m/s, it may be useful to apply the AANEM2 criteria and inching test to diagnose ulnar neuropathy.
Abstract
Objective To demonstrate the prevalence and characteristics of subclinical ulnar neuropathy at the elbow in diabetic patients.Methods One hundred and five patients with diabetes mellitus were recruited for the study of ulnar nerve conduction analysis. Clinical and demographic characteristics were assessed. Electrodiagnosis of ulnar neuropathy at the elbow was based on the criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM1 and AANEM2). The inching test of the ulnar motor nerve was additionally performed to localize the lesion.Results The duration of diabetes, the existence of diabetic polyneuropathy (DPN) symptoms, the duration of symptoms, and HbA1C showed significantly larger values in the DPN group (p<0.05). Ulnar neuropathy at the elbow was more common in the DPN group. There was a statistically significant difference in the number of cases that met the three diagnostic criteria between the no DPN group and the DPN group. The most common location for ulnar mononeuropathy at the elbow was the retrocondylar groove.Conclusion Ulnar neuropathy at the elbow is more common in patients with DPN. If the conduction velocities of both the elbow and forearm segments are decreased to less than 50 m/s, it may be useful to apply the AANEM2 criteria and inching test to diagnose ulnar neuropathy.
참고문헌 (17)
- Partanen J, "Natural history of peripheral neuropathy in patients with non-insulin-dependent diabetes mellitus", N Engl J Med, 333, pp.89~94 (1995)
- Vinik A, "Focal entrapment neuropathies in diabetes", Diabetes Care, 27, pp.1783~1788 (2004)
- Schady W, "Observations on severe ulnar neuropathy in diabetes", J Diabetes Complications, 12, pp.128~132 (1998)
- Acosta JA, "Ulnar neuropathy in the forearm: a possible complication of diabetes mellitus", Muscle Nerve, 28, pp.40~45 (2003)
- Mondelli M, "Ulnar neuropathy at the elbow in diabetes", Am J Phys Med Rehabil, 88, pp.278~285 (2009)
- Hawley J, "Localizing ulnar nerve lesions by motor nerve conduction study", Electromyogr Clin Neurophysiol, 27, pp.385~392 (1987)
- Kim DH, "Localization of ulnar neuropathy at the elbow using new stimulator for the inching test", Clin Neurophysiol, 115, pp.1021~1026 (2004)
- 김동휘, "당뇨병성감각운동다발신경병에서 전기진단검사의 진료지침", 대한근전도 전기진단의학회지, 14(2), pp.47~54 (2012), 대한근전도전기진단의학회
- 권희규, "당뇨병성 신경병증 심도에 따른 수근관 증후군의 동반 빈도", Annals of Rehabilitation Medicine, 29(3), pp.272~275 (2005), 대한재활의학회
- The Diabetes Control and Complications Trial Research Group, "The effect of intensive diabetes therapy on the development and progression of neuropathy", Ann Intern Med, 122, pp.561~568 (1995)
- Landau ME, "Clinical features and electrodiagnosis of ulnar neuropathies", Phys Med Rehabil Clin N Am, 24, pp.49~66 (2013)
- American Association of Electrodiagnostic Medicine, "Practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow: summary statement", Muscle Nerve, 22, pp.408~411 (1999)
- Boonyapisit K, "Lumbrical and interossei recording in severe carpal tunnel syndrome", Muscle Nerve, 25, pp.102~105 (2002)
- 박동식, "경증의 수근관증후군에서 여러 전기진단학적 지표들의 유용성", 대한근전도 전기진단의학회지, 10(2), pp.135~143 (2008), 대한근전도전기진단의학회
- Dumitru D, "Electrodiagnostic medicine" (2002), Hanley & Belfus
- Dyck PJ, "The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study", Neurology, 43, pp.817~824 (1993)
- Bergenheim T, "Sensory thresholds for vibration, perception and pain in diabetic patients aged 15-50 years", Diabetes Res Clin Pract, 16, pp.47~52 (1992)